Cancer treatment and research communications · 2026
Real-world analysis of treatments, healthcare costs, and overall survival among patients with metastatic non-small cell lung cancer by molecular biomarker testing approach.
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Wiedower Julie A, Stockl Karen M, Tucker Jamie, Forbes Shaun P, Zhang Nicole, Clemens Keelia, Certa Julia M, Morin Pamela, Langer Lucy
Аннотация
PURPOSE: To evaluate biomarker-targeted therapy utilization, healthcare costs, and overall survival (OS) with comprehensive genomic profiling (CGP), small panel, or no molecular testing for patients with metastatic non-small cell lung cancer (mNSCLC).
PATIENTS AND METHODS: This retrospective claims analysis identified patients with newly diagnosed mNSCLC (index date) from 08/01/2020-12/31/2022, using the Optum Labs Data Warehouse. Patients were grouped by first molecular testing approach: 1) CGP (>50 genes); 2) small panel (individual gene or ≤50 gene panel); or 3) no molecular testing. Post-diagnosis outcomes assessed during variable follow-up included biomarker-targeted therapy use, healthcare costs per patient per month (PPPM) during the first 180 days, and OS.
RESULTS: Among 8783 patients identified, the molecular testing approach consisted of 41.4% CGP, 30.3% small panel, 23.4% no testing, and 4.9% unassigned. For CGP, the specimen type was 40.6% blood, 37.2% tissue, 2.8% blood and tissue, and 19.4% undefined. Use of biomarker-targeted therapy was higher with CGP than small panel testing (12.4%vs. 7.7%, P < 0.001). In an exploratory analysis, biomarker-targeted therapy use was higher with blood vs. tissue CGP (14.3%vs. 11.2%, P = 0.01). Among treated patients, adjusted OS did not differ significantly for CGP and small panel testing (HR 1.03, 95% CL 0.94 to 1.12, P = 0.58). Among treated patients, mean total healthcare costs PPPM were similar between CGP and small panel testing across both Medicare Advantage ($17,974 vs. $17,593, P = 0.31) and commercial ($40,655 vs. $39,802, P = 0.68) insurance and remained consistent after adjusting for baseline characteristics.
CONCLUSION: In mNSCLC, patients with CGP received biomarker-targeted therapy at higher rates than patients with small panel testing. Among treated patients, adjusted analyses showed no statistically significant difference in OS between CGP and small panel testing, and total healthcare costs were comparable between testing approaches.
PATIENTS AND METHODS: This retrospective claims analysis identified patients with newly diagnosed mNSCLC (index date) from 08/01/2020-12/31/2022, using the Optum Labs Data Warehouse. Patients were grouped by first molecular testing approach: 1) CGP (>50 genes); 2) small panel (individual gene or ≤50 gene panel); or 3) no molecular testing. Post-diagnosis outcomes assessed during variable follow-up included biomarker-targeted therapy use, healthcare costs per patient per month (PPPM) during the first 180 days, and OS.
RESULTS: Among 8783 patients identified, the molecular testing approach consisted of 41.4% CGP, 30.3% small panel, 23.4% no testing, and 4.9% unassigned. For CGP, the specimen type was 40.6% blood, 37.2% tissue, 2.8% blood and tissue, and 19.4% undefined. Use of biomarker-targeted therapy was higher with CGP than small panel testing (12.4%vs. 7.7%, P < 0.001). In an exploratory analysis, biomarker-targeted therapy use was higher with blood vs. tissue CGP (14.3%vs. 11.2%, P = 0.01). Among treated patients, adjusted OS did not differ significantly for CGP and small panel testing (HR 1.03, 95% CL 0.94 to 1.12, P = 0.58). Among treated patients, mean total healthcare costs PPPM were similar between CGP and small panel testing across both Medicare Advantage ($17,974 vs. $17,593, P = 0.31) and commercial ($40,655 vs. $39,802, P = 0.68) insurance and remained consistent after adjusting for baseline characteristics.
CONCLUSION: In mNSCLC, patients with CGP received biomarker-targeted therapy at higher rates than patients with small panel testing. Among treated patients, adjusted analyses showed no statistically significant difference in OS between CGP and small panel testing, and total healthcare costs were comparable between testing approaches.