Steven Haken is great for drawing attention to important recent papers. This week, he also flagged Hofmarcher et al. (2023), a excellent paper on the value created by precision medicine, case in point, non small cell lung cancer (NSCLC).
https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2023.1119506/full
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- Pair Hofmarcher 2023, with Bogdan et al. 2024, Clinical Utility of NGS Panel...advanced solid tumors; open access here, and covered in July at Precision Medicine Online by Alison Kanski, here.
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Here are five key takeaway pointson the value of precision medicine (PM) in non-small cell lung cancer (NSCLC), based on the Hofmarcher 2023 paper:
Survival Benefits of Precision Medicine: The study highlights the significant improvement in survival rates with the use of multigene testing in advanced non-small cell lung cancer (aNSCLC). Compared to no testing, the five-year survival rate increased dramatically from 2% to 13-19% with multigene testing, demonstrating the life-extending potential of precision medicine when applied to genomic testing of each patient's cancer.
Reduction in Treatment-Related Adverse Events: The paper underscores that multigene testing not only improves survival but also reduces the incidence of treatment-related adverse events (AEs). With multigene testing, the occurrence of AEs dropped by up to 72% in the first year, which enhances the overall quality of life for patients undergoing cancer treatment.
Cost-Effectiveness of Multigene Testing: Although multigene testing initially increases healthcare costs due to the higher prices of newer targeted therapies and the cost of the tests themselves, these are partially offset by reductions in other medical expenses, such as the treatment of adverse events and end-of-life care. This suggests that while the upfront costs are higher, the long-term benefits of more accurate and effective treatment provide substantial value.
Global Variability in Outcomes: The study shows that the benefits of precision medicine are not uniform across all regions. For example, East Asian countries, where there is a higher prevalence of targetable mutations like EGFR, saw the most significant improvements in survival rates. This indicates the importance of tailoring precision medicine strategies to the genetic profiles of different populations.
Broader Societal Impact: Beyond direct healthcare costs, the study also considers the societal benefits of precision medicine, such as reduced non-healthcare costs (e.g., sick leave and disability pensions) due to prolonged survival and better quality of life. These factors are crucial in evaluating the full impact of precision medicine, making a compelling case for its broader adoption.
These points emphasize the clinical and economic value of precision medicine in NSCLC, reinforcing its importance in modern oncology practice.
