Cost-effectiveness analysis comparing companion diagnostic tests for EGFR, ALK, and ROS1 versus next-generation sequencing (NGS) in advanced adenocarcinoma lung cancer patients.

摘要: The treatment of choice for advanced non–small cell lung cancer is selected according to the presence specific alterations. Patients should undergo molecular testing relevant modifications and mutational status EGFR translocation ALK ROS1 are commonly tested offer best intervention. In addition, tests costs also be taken in consideration. Therefore, this work was performed order evaluate cost-effectiveness a unique exam using NGS (next generation sequencing) versus other routinely used which involve RT-PCR FISH. target population NSCLC, adenocarcinoma, candidates first-line therapy. Two strategies were undertaken, strategy 1 corresponded sequential with RT-PCR, then FISH ROS1. Strategy 2 differed from that simultaneously by 3 considered single test next-generation sequencing, platform includes EGFR, genes. A decision tree analysis model genetic options. From results, microsimulation nested estimate survival outcomes therapeutic use added 24% extra true cases as well attributed testing. ICER comparing US$ 3479.11/correct case detected. improved slight gain life years QALYs. Our results indicated that, although precise, diagnosis patients stage NSCLC adenocarcinoma histology not cost-effective terms quality-adjusted perspective Brazilian supplementary health system.