Could molecular pathology testing in lung cancer be more cost effective?
Abstract
Aims: EGFR and ALK analysis is routinely undertaken prior to targeted treatment of non-squamous non-small cell lung carcinoma (NSCLC). Increasingly limited resources require molecular pathology services to be cost effective without detriment to patient care. Methods: Data from an audit of molecular pathology testing in the South East of Scotland Cancer network has been used to explore different testing strategies with the aim of reducing costs; including investigation of TTF1 expression as a negative predictor for EGFR mutations. Results: TTF1 immunohistochemistry had a high negative predictive value for EGFR mutations (99%). Reflex testing all non-squamous NSCLC had the highest costs whereas limiting testing to those who might be considered for treatment would save 7.5%; the serial model could save 32.7%. Conclusions: Testing only patients being considered for EGFR and ALK inhibitors represented small savings; more significant savings would be achievable if testing algorithms utilized known associations between clinical biomarkers.
Citation
Walsh , K , Kheng , Y , Oniscu , A , Harrison , D J & Wallace , W 2016 , ' Could molecular pathology testing in lung cancer be more cost effective? ' , Journal of Clinical Pathology , vol. 69 , no. 10 , pp. 938-941 . https://doi.org/10.1136/jclinpath-2016-203811
Publication
Journal of Clinical Pathology
Status
Peer reviewed
ISSN
0021-9746Type
Journal article
Collections
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