Cost-effectiveness of precision medicine in gastrointestinal stromal tumor and gastric adenocarcinoma

• Type of Material: Article
• Authors: Simon B Zeichner, Emory University; Daniel Goldstein, Emory University; Christine Kohn, University of Saint Joseph School of Pharmacy; Christopher Flowers, Emory University
• Language: English
• Date: 2017-06-01
• Publisher: AME Publishing Co
• Publication Version: Final Published Version
• Copyright Statement: © Journal of Gastrointestinal Oncology. All rights reserved.
• Final Published Version (URL): http://dx.doi.org/10.21037/jgo.2016.04.03
• Title of Journal or Parent Work: Journal of Gastrointestinal Oncology
• Volume: 8
• Issue: 3
• Start Page: 513
• End Page: 523
• Keywords: Cost-effectiveness; targeted agents; ADJUVANT IMATINIB; IN-SITU HYBRIDIZATION; OF-FUNCTION MUTATIONS; GENE STATUS; gastrointestinal stromal tumor (GIST); Gastroenterology & Hepatology; PDGFRA MUTATIONS; GASTROESOPHAGEAL JUNCTION ADENOCARCINOMA; Oncology; Life Sciences & Biomedicine; UNITED-STATES; SCORING SYSTEM; gastric adenocarcinoma (GA); cost; Science & Technology; PHASE-II TRIAL; 2ND-LINE TREATMENT
• Research Categories: Health Sciences, Oncology

Abstract

Over the past 20 years, with the incorporation of genetic sequencing and improved understanding regarding the mechanisms of cancer growth/metastasis, novel targets and their associated treatments have emerged in oncology and are now regularly incorporated into the clinical care of patients in the US. Novel, more tumor-specific, non-chemotherapy agents, including agents that are commonly used in the treatment of patients with gastric adenocarcinoma (GA) and gastrointestinal stromal tumor (GIST), fall under a broader treatment strategy, termed "precision medicine". While diagnostic testing and associated treatments in metastatic GA (mGA) are costly and may produce marginal benefit, those associated with GIST, despite being costly, produce significant improvements in patient outcomes. Despite the significant difference in impact, the agents associated with these cancers have similar acquisition costs. In this paper, we will review the current literature regarding cost and cost-effectiveness associated with precision medicine diagnosis and treatment strategies for GA and GIST.