Real-world analysis of treatments, healthcare costs, and overall survival among patients with metastatic non-small cell lung cancer by molecular biomarker testing approach.

IF 3.5 Q3 Medicine

Cancer treatment and research communications Pub Date : 2026-10-16 DOI:10.1016/j.ctarc.2026.101479

Julie A Wiedower, Karen M Stockl, Jamie Tucker, Shaun P Forbes, Nicole Zhang, Keelia Clemens, Julia M Certa, Pamela Morin, Lucy Langer

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引用次数: 0

Abstract

Purpose: To evaluate biomarker-targeted therapy utilization, healthcare costs, and overall survival (OS) with comprehensive genomic profiling (CGP), small panel, or no molecular testing for patients with metastatic non-small cell lung cancer (mNSCLC).

Patients and methods: This retrospective claims analysis identified patients with newly diagnosed mNSCLC (index date) from 08/01/2020-12/31/2022, using the Optum Labs Data Warehouse. Patients were grouped by first molecular testing approach: 1) CGP (>50 genes); 2) small panel (individual gene or ≤50 gene panel); or 3) no molecular testing. Post-diagnosis outcomes assessed during variable follow-up included biomarker-targeted therapy use, healthcare costs per patient per month (PPPM) during the first 180 days, and OS.

Results: Among 8783 patients identified, the molecular testing approach consisted of 41.4% CGP, 30.3% small panel, 23.4% no testing, and 4.9% unassigned. For CGP, the specimen type was 40.6% blood, 37.2% tissue, 2.8% blood and tissue, and 19.4% undefined. Use of biomarker-targeted therapy was higher with CGP than small panel testing (12.4%vs. 7.7%, P < 0.001). In an exploratory analysis, biomarker-targeted therapy use was higher with blood vs. tissue CGP (14.3%vs. 11.2%, P = 0.01). Among treated patients, adjusted OS did not differ significantly for CGP and small panel testing (HR 1.03, 95% CL 0.94 to 1.12, P = 0.58). Among treated patients, mean total healthcare costs PPPM were similar between CGP and small panel testing across both Medicare Advantage ($17,974 vs. $17,593, P = 0.31) and commercial ($40,655 vs. $39,802, P = 0.68) insurance and remained consistent after adjusting for baseline characteristics.

Conclusion: In mNSCLC, patients with CGP received biomarker-targeted therapy at higher rates than patients with small panel testing. Among treated patients, adjusted analyses showed no statistically significant difference in OS between CGP and small panel testing, and total healthcare costs were comparable between testing approaches.

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通过分子生物标志物检测方法对转移性非小细胞肺癌患者的治疗、医疗费用和总生存率进行现实世界分析。

目的：通过综合基因组分析（CGP）、小小组或无分子检测评估转移性非小细胞肺癌（mNSCLC）患者的生物标志物靶向治疗利用率、医疗成本和总生存期（OS）。患者和方法：本回顾性索赔分析使用Optum实验室数据仓库，确定了2020年8月1日至2022年12月31日期间新诊断的小细胞肺癌患者（索引日期）。采用第一分子检测方法对患者进行分组：1)CGP （bb0 ~ 50个基因）；2)小面板（单个基因或≤50个基因面板）；或者3)不做分子检测。在可变随访期间评估的诊断后结果包括生物标志物靶向治疗的使用，前180天每位患者每月的医疗保健费用（PPPM）和OS。结果：在确定的8783例患者中，分子检测方法包括41.4%的CGP， 30.3%的小组，23.4%的未检测和4.9%未分配。对于CGP，标本类型为40.6%血液，37.2%组织，2.8%血液和组织，19.4%未定义。CGP的生物标志物靶向治疗的使用率高于小组试验（12.4%vs. 12.4%）。结论：在小细胞肺癌中，CGP患者接受生物标志物靶向治疗的比例高于小面板检测患者。在接受治疗的患者中，调整后的分析显示，CGP和小小组试验之间的OS无统计学意义差异，两种试验方法之间的总医疗成本相当。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cancer treatment and research communications Medicine-Oncology

CiteScore

4.30

自引率

0.00%

发文量

148

审稿时长

56 days

期刊介绍： Cancer Treatment and Research Communications is an international peer-reviewed publication dedicated to providing comprehensive basic, translational, and clinical oncology research. The journal is devoted to articles on detection, diagnosis, prevention, policy, and treatment of cancer and provides a global forum for the nurturing and development of future generations of oncology scientists. Cancer Treatment and Research Communications publishes comprehensive reviews and original studies describing various aspects of basic through clinical research of all tumor types. The journal also accepts clinical studies in oncology, with an emphasis on prospective early phase clinical trials. Specific areas of interest include basic, translational, and clinical research and mechanistic approaches; cancer biology; molecular carcinogenesis; genetics and genomics; stem cell and developmental biology; immunology; molecular and cellular oncology; systems biology; drug sensitivity and resistance; gene and antisense therapy; pathology, markers, and prognostic indicators; chemoprevention strategies; multimodality therapy; cancer policy; and integration of various approaches. Our mission is to be the premier source of relevant information through promoting excellence in research and facilitating the timely translation of that science to health care and clinical practice.