K-Ras and BRAF mutation screening diagnostic data

Researchers at the foundation reported data from a simulated cost-effectiveness analysis showing that screening for K-Ras mutations prior to starting treatment with cetuximab saves about $7,500 over 10 years in mCRC patients compared with no screening ($57,348 vs. $64,841). However, the researchers found that the incremental cost effectiveness ratio (ICER) per LYS gained with screening is still above "the generally accepted threshold" of an acceptable cost-effectiveness ratio. Screening for K-Ras mutations prior to starting treatment with cetuximab had an ICER per LYS of $2,814,338 vs. $2,932,767 for cetuximab treatment without screening for K-Ras mutations. The researchers also estimated that the OS between the screening (0.7029 years) and no screening (0.7055 years) groups was less than 1 day. Additionally, the ICER per LYS for screening for both K-Ras and BRAF mutations prior to starting treatment was $648,396 and led to an OS of 0.7025 years at a cost of $56,324 over 10 years. The simulation used a scenario of no anti- EGFR therapy as a baseline, which led to an OS of 0.6686 years at a cost of $34,291 over 10 years. The analysis was based on 50,000 simulations of a cohort of 10,000 patients with mCRC. Data were published in the Journal of the National Cancer Institute.

In an editorial accompanying the paper, researchers at the Fred Hutchinson Cancer Research Center said that the clinical and economic rationale for K-Ras mutation screening is "highly apparent," noting that molecular testing is as much about generating cost savings by identifying non-responders as it is about improving survival by identifying responders. ...