Precision oncology in advanced cancer patients improves overall survival with lower weekly healthcare costs
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Derrick S. Haslem1, Ingo Chakravarty2, Gail Fulde1, Heather Gilbert1, Brian P. Tudor1, Karen Lin1, James M. Ford3 and Lincoln D. Nadauld1,3
1Precision Genomics Program, Intermountain Healthcare, Saint George, UT, United States of America
2Navican Genomics, Intermountain Healthcare, San Diego, CA, United States of America
3Division of Oncology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, United States of America
Lincoln D. Nadauld, email: firstname.lastname@example.org
Keywords: precision medicine, oncology, outcomes, costs, overall survival
Received: May 17, 2017 Accepted: September 15, 2017 Published: February 02, 2018
The impact of precision oncology on guiding treatment decisions of late-stage cancer patients was previously studied in a retrospective analysis. However, the overall survival and costs were not previously evaluated. We report the overall survival and healthcare costs associated with precision oncology in these patients with advanced cancer. Building on a matched cohort study of 44 patients with metastatic cancer who received all of their care within a single institution, we evaluated the overall survival and healthcare costs for each patient. We analyzed the outcomes of 22 patients who received genomic testing and targeted therapy (precision oncology) between July 1, 2013 and January 31, 2015, and compared to 22 historically controlled patients (control) who received standard chemotherapy (N = 17) or best supportive care (N = 5). The median overall survival was 51.7 weeks for the targeted treatment group and 25.8 weeks for the control group (P = 0.008) when matching on age, gender, histological diagnosis and previous treatment lines. Average costs over the entire period were $2,720 per week for the targeted treatment group and $3,453 per week for the control group, (P = 0.036). A separate analysis of 1,814 patients with late-stage cancer diagnoses found that those who received a targeted cancer treatment (N = 93) had 6.9% lower costs in the last 3 months of life compared with those who did not. These findings suggest that precision oncology may improve overall survival for refractory cancer patients while lowering average per-week healthcare costs, resource utilization and end-of-life costs.
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