Paediatric and Adult Solid Tumours Exhibiting NTRK Gene Fusions in Australia, 2020-2044: A Population-Based Statistical Modelling Study.

BACKGROUND

TRK inhibitors targeting NTRK fusion-positive cancers have the potential to improve patient outcomes, but also have high costs. We report the first long-term projections of cancer prevalence associated with NTRK gene fusions in Australia, to 2044.

METHODS

We analysed national Australian Institute of Health and Welfare incidence (1982-2019) and survival (1991-2019), NSW Enduring Cancer Data Linkage incidence (1982-2019) and survival data (1982-2019). We projected 1-year to 5-year cancer prevalence using validated statistical methods, for all stages combined, advanced disease at diagnosis (here, distant metastasis/lymph node involvement), and advanced disease after progression post-diagnosis. We estimated prevalence for all paediatric cancers combined (age < 18 years at diagnosis), all adult solid cancers combined, 18 cancer types/groups, and 5 cancer sub-types relevant to current Australian government subsidies of TRK inhibitors.

RESULTS

For all solid cancers combined, we project increasing prevalence of individuals who were diagnosed with tumours exhibiting NTRK gene fusions, primarily due to population growth and ageing. For example, for 2-year prevalence (aligning with 2.5 years average treatment assumed in previous economic assessments for a TRK inhibitor subsidy), the projected increases from 2019 to 2044 are: all stages combined, paediatric cancers 80 to 106 (+ 32.5%), adult cancers 645 to 970 (+ 50.4%); advanced disease at diagnosis, paediatric cancers 19 to 23 (+ 21.1%), adult cancers 185 to 261 (+ 41.1%); advanced disease after progression post-diagnosis, paediatric cancers 22 to 30 (+ 36.4%), adult cancers 110 to 180 (+ 63.6%).

CONCLUSION

The results from this study can support healthcare planning and budget forecasts, including for different potential government treatment subsidy scenarios.