ArticleJournal of the National Cancer Institute2012
Cost-effectiveness analysis of screening for KRAS and BRAF mutations in metastatic colorectal cancer.
Article in Journal of the National Cancer Institute, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 8 of them syntheses that pooled it.
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Who cites it
41 citing papers in PubMed, 8 syntheses or guidelines pooled it, 96 citations in OpenAlex.
- Treatment of Metastatic Colorectal Cancer: ASCO Guideline.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2023Pooled it
- Health Economic Models for Metastatic Colorectal Cancer: A Methodological Review.PharmacoEconomics · 2020Pooled it
- Economic Value of Pharmacogenetic Testing for Cancer Drugs with Clinically Relevant Drug-Gene Associations: A Systematic Literature Review.Journal of managed care & specialty pharmacy · 2019Pooled it
- Do cancer biomarkers make targeted therapies cost-effective? A systematic review in metastatic colorectal cancer.PloS one · 2018Pooled it
- Cost-Effectiveness of Pharmacogenomic and Pharmacogenetic Test-Guided Personalized Therapies: A Systematic Review of the Approved Active Substances for Personalized Medicine in Germany.Advances in therapy · 2016Pooled it
- Metastatic Colorectal Cancer: A Systematic Review of the Value of Current Therapies.Clinical colorectal cancer · 2016Pooled it
- A Systematic Review of Health Economic Evaluations of Diagnostic Biomarkers.Applied health economics and health policy · 2016Pooled it
- Economic Evaluations of Pharmacogenetic and Pharmacogenomic Screening Tests: A Systematic Review. Second Update of the Literature.PloS one · 2016Pooled it
- Trial
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- Has the development of cancer biomarkers to guide treatment improved health outcomes?The European journal of health economics : HEPAC : health economics in prevention and care · 2021Article
- The Sensitivity and Specificity of Novel Primers for Detection of BRAFV600E Mutation.Asian Pacific journal of cancer prevention : APJCP · 2020Article
- Cost-effectiveness analysis of fruquintinib for metastatic colorectal cancer third-line treatment in China.BMC cancer · 2020Article
- Molecular biomarkers and precision medicine in colorectal cancer: a systematic review of health economic analyses.Oncotarget · 2019Review
- Acceptability and feasibility study of patient-specific 'tumouroids' as personalised treatment screening tools: Protocol for prospective tissue and data collection of participants with confirmed or suspected renal cell carcinoma.International journal of surgery protocols · 2019Article
- Consequences of Biomarker Analysis on the Cost-Effectiveness of Cetuximab in Combination with FOLFIRI as a First-Line Treatment of Metastatic Colorectal Cancer: Personalised Medicine at Work.Applied health economics and health policy · 2018Article
- Personalized Medicine and Pay for Performance: Should Pharmaceutical Firms be Fully Penalized when Treatment Fails?PharmacoEconomics · 2018Article
- Correlation between clinicopathological features andInternational journal of clinical and experimental pathology · 2018Article
- Personalized medicine in colorectal cancer diagnosis and treatment: a systematic review of health economic evaluations.Cost effectiveness and resource allocation : C/E · 2018Review
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7 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundIn 2009, the American Society of Clinical Oncology recommended that patients with metastatic colorectal cancer (mCRC) who are candidates for anti-epidermal growth factor receptor (EGFR) therapy have their tumors tested for KRAS mutations because tumors with such mutations do not respond to anti-EGFR therapy. Limiting anti-EGFR therapy to those without KRAS mutations will reserve treatment for those likely to benefit while avoiding unnecessary costs and harm to those who would not. Similarly, tumors with BRAF genetic mutations may not respond to anti-EGFR therapy, though this is less clear. Economic analyses of mutation testing have not fully explored the roles of alternative therapies and resection of metastases.
methodsThis paper is based on a decision analytic framework that forms the basis of a cost-effectiveness analysis of screening for KRAS and BRAF mutations in mCRC in the context of treatment with cetuximab. A cohort of 50 000 patients with mCRC is simulated 10 000 times, with attributes randomly assigned on the basis of distributions from randomized controlled trials.
resultsScreening for both KRAS and BRAF mutations compared with the base strategy (of no anti-EGFR therapy) increases expected overall survival by 0.034 years at a cost of $22 033, yielding an incremental cost-effectiveness ratio of approximately $650 000 per additional year of life. Compared with anti-EGFR therapy without screening, adding KRAS testing saves approximately $7500 per patient; adding BRAF testing saves another $1023, with little reduction in expected survival.
conclusionsScreening for KRAS and BFAF mutation improves the cost-effectiveness of anti-EGFR therapy, but the incremental cost effectiveness ratio remains above the generally accepted threshold for acceptable cost effectiveness ratio of $100 000/quality adjusted life year.
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