Featured Research

from universities, journals, and other organizations

KRAS and BRAF mutation screening in metastatic colorectal cancer costly in relation to benefits

Date:
November 28, 2012
Source:
Journal of the National Cancer Institute
Summary:
Researchers report that screening for KRAS and BRAF mutations can reduce the cost of anti-EGFR treatment for metastatic colorectal cancer but with a very small reduction in overall survival according to a new study.

Researchers report that screening for KRAS and BRAF mutations can reduce the cost of anti-EGFR treatment for metastatic colorectal cancer but with a very small reduction in overall survival according to a new study published on November 28 in the Journal of the National Cancer Institute.

Metastatic colorectal cancer patients whose tumors harbor mutations in KRAS (and to a lesser extent, in BRAF) are unlikely to respond to costly anti-EGFR therapies. Screening of patients who are candidates for these therapies for mutations in one of these genes (KRAS) has been recommended, with the goal of providing treatment to those who are likely to benefit from it while avoiding unnecessary costs and harm to those who are not likely to benefit. However, the real-world impact of mutation screening for both KRAS and BRAF is unclear.

To better understand the impact of mutation screening with regard to health outcomes, costs, and value, Ajay S. Behl, Ph.D., M.B.A., of the HealthPartners Research Foundation in Bloomington, Minnesota, and colleagues, performed a cost-effectiveness analysis that took into account the treatments, resection of metastases, and survival for the different types of metastases. They conducted patient-level decision analytic simulation modeling comparing four strategies involving KRAS and BRAF mutation testing to select treatments for metastatic colorectal cancer patients: no anti-EGFR therapy (best supportive care); anti-EGFR therapy without screening; screening for KRAS mutations only (before providing anti-EGFR therapy); and screening for KRAS and BRAF mutations (before providing anti-EGFR therapy).

The researchers found that compared with no anti-EGFR therapy, screening for both KRAS and BRAF mutations showed a very high (ie, unfavorable) incremental cost-effectiveness ratio, meaning it was very costly in relation to its benefits. Compared with anti-EGFR therapy without screening, screening for KRAS mutations saved approximately $7,500 per patient; adding BRAF mutation screening saved another $1023, with little reduction in expected survival.

The authors write, "In general, our results are less supportive of the use of anti-EGFR therapy than previous analyses, and they indicate lower cost savings from KRAS testing than previously reported. Although we cannot confirm that anti-EGFR therapy is a cost-effective use of health care resources, we can affirm that KRAS testing is cost-saving. BRAF testing may offer additional savings."

In an accompanying editorial, Josh J. Carlson, M.P.H., Ph.D., of the Department of Pharmacy, University of Washington, and Scott D. Ramsey, MD, PhD, of the Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, both in Seattle, note two practical points highlighted by the study: that molecular testing is as much about generating cost savings by identifying nonresponders as it is about improving survival by identifying responders, and that good modeling must account for the fact that community practice (as opposed to clinical trials) "is messy." They write, "most importantly, this study of an unusually accurate test raises important issues that should be considered for other molecular tests in other settings."


Story Source:

The above story is based on materials provided by Journal of the National Cancer Institute. Note: Materials may be edited for content and length.


Journal Reference:

  1. Ajay S. Behl, Katrina A. B. Goddard, Thomas J. Flottemesch, David Veenstra, Richard T. Meenan, Jennifer S. Lin, and Michael V. Maciosek. Cost-Effectiveness Analysis of Screening for KRAS and BRAF Mutations in Metastatic Colorectal Cancer. J Natl Cancer Inst, November 28, 2012 DOI: 10.1093/jnci/djs433

Cite This Page:

Journal of the National Cancer Institute. "KRAS and BRAF mutation screening in metastatic colorectal cancer costly in relation to benefits." ScienceDaily. ScienceDaily, 28 November 2012. <www.sciencedaily.com/releases/2012/11/121128162159.htm>.
Journal of the National Cancer Institute. (2012, November 28). KRAS and BRAF mutation screening in metastatic colorectal cancer costly in relation to benefits. ScienceDaily. Retrieved August 21, 2014 from www.sciencedaily.com/releases/2012/11/121128162159.htm
Journal of the National Cancer Institute. "KRAS and BRAF mutation screening in metastatic colorectal cancer costly in relation to benefits." ScienceDaily. www.sciencedaily.com/releases/2012/11/121128162159.htm (accessed August 21, 2014).

Share This




More Health & Medicine News

Thursday, August 21, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Drug Used To Treat 'Ebola's Cousin' Shows Promise

Drug Used To Treat 'Ebola's Cousin' Shows Promise

Newsy (Aug. 21, 2014) An experimental drug used to treat Marburg virus in rhesus monkeys could give new insight into a similar treatment for Ebola. Video provided by Newsy
Powered by NewsLook.com
Cadavers, a Teen, and a Medical School Dream

Cadavers, a Teen, and a Medical School Dream

AP (Aug. 21, 2014) Contains graphic content. He's only 17. But Johntrell Bowles has wanted to be a doctor from a young age, despite the odds against him. He was recently the youngest participant in a cadaver program at the Indiana University NW medical school. (Aug. 21) Video provided by AP
Powered by NewsLook.com
American Ebola Patients Released: What Cured Them?

American Ebola Patients Released: What Cured Them?

Newsy (Aug. 21, 2014) It's unclear whether the American Ebola patients' recoveries can be attributed to an experimental drug or early detection and good medical care. Video provided by Newsy
Powered by NewsLook.com
Lost Brain Cells To Blame For Sleep Problems Among Seniors

Lost Brain Cells To Blame For Sleep Problems Among Seniors

Newsy (Aug. 21, 2014) According to a new study, elderly people might have trouble sleeping because of the loss of a certain group of neurons in the brain. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins