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Genetic screen not worth cost for node-negative breast cancer patients

Using a 70-gene signature screening tool for adjuvant chemotherapy decisions cost significantly more than did other methods, including giving chemotherapy to all patients, but did not confer any additional advantages in survival or quality of life, for women with node-negative breast cancer.

The estimated cost per woman with a node-negative tumor was 12,780 euros for using the MammaPrint test – significantly higher than either an online decision tool, or a strategy of systematic chemotherapy for all, according to Julia Bonastre, Ph.D., and her colleagues (J. Clin. Oncol. 2014 October [doi:10.1200/JCO.2013.54.9931]).

©Kativ/iStockphoto
Molecular tests yield modest health benefits, but their high cost results in poor value for the money, according to researchers.

The study compared cost and clinical outcomes among 307 women treated for node-negative breast cancers as part of a MammaPrint validation trial. Chemotherapy choice was guided either by MammaPrint, the Adjuvant! Online program, or a scheme of systematic chemotherapy for every patient.

The mean cost of the 70-gene MammaPrint profile was 12,780 euros; the mean cost of Adjuvant! Online, 10,743 euros; and the mean cost of systematic chemotherapy, 12,123 euros. Over the 10-year follow-up period, there were no differences in life-years or quality-adjusted life-years.

Treatment de-escalation is critical for ensuring high-quality survivorship over the long term, wrote Dr. Bonastre of Gustave Roussy Institute of Oncology, Paris, and her associates. “However, our study shows that the health benefits associated with the use of molecular tests are modest. In addition, the high price of these tests results in poor value for the money, limiting their usefulness in routine practice,” they said.

The study was funded by the French National Cancer Institute, and the authors reported no conflicts of interest.

msullivan@frontlinemedcom.com

On Twitter @alz_gal

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Using a 70-gene signature screening tool for adjuvant chemotherapy decisions cost significantly more than did other methods, including giving chemotherapy to all patients, but did not confer any additional advantages in survival or quality of life, for women with node-negative breast cancer.

The estimated cost per woman with a node-negative tumor was 12,780 euros for using the MammaPrint test – significantly higher than either an online decision tool, or a strategy of systematic chemotherapy for all, according to Julia Bonastre, Ph.D., and her colleagues (J. Clin. Oncol. 2014 October [doi:10.1200/JCO.2013.54.9931]).

©Kativ/iStockphoto
Molecular tests yield modest health benefits, but their high cost results in poor value for the money, according to researchers.

The study compared cost and clinical outcomes among 307 women treated for node-negative breast cancers as part of a MammaPrint validation trial. Chemotherapy choice was guided either by MammaPrint, the Adjuvant! Online program, or a scheme of systematic chemotherapy for every patient.

The mean cost of the 70-gene MammaPrint profile was 12,780 euros; the mean cost of Adjuvant! Online, 10,743 euros; and the mean cost of systematic chemotherapy, 12,123 euros. Over the 10-year follow-up period, there were no differences in life-years or quality-adjusted life-years.

Treatment de-escalation is critical for ensuring high-quality survivorship over the long term, wrote Dr. Bonastre of Gustave Roussy Institute of Oncology, Paris, and her associates. “However, our study shows that the health benefits associated with the use of molecular tests are modest. In addition, the high price of these tests results in poor value for the money, limiting their usefulness in routine practice,” they said.

The study was funded by the French National Cancer Institute, and the authors reported no conflicts of interest.

msullivan@frontlinemedcom.com

On Twitter @alz_gal

Using a 70-gene signature screening tool for adjuvant chemotherapy decisions cost significantly more than did other methods, including giving chemotherapy to all patients, but did not confer any additional advantages in survival or quality of life, for women with node-negative breast cancer.

The estimated cost per woman with a node-negative tumor was 12,780 euros for using the MammaPrint test – significantly higher than either an online decision tool, or a strategy of systematic chemotherapy for all, according to Julia Bonastre, Ph.D., and her colleagues (J. Clin. Oncol. 2014 October [doi:10.1200/JCO.2013.54.9931]).

©Kativ/iStockphoto
Molecular tests yield modest health benefits, but their high cost results in poor value for the money, according to researchers.

The study compared cost and clinical outcomes among 307 women treated for node-negative breast cancers as part of a MammaPrint validation trial. Chemotherapy choice was guided either by MammaPrint, the Adjuvant! Online program, or a scheme of systematic chemotherapy for every patient.

The mean cost of the 70-gene MammaPrint profile was 12,780 euros; the mean cost of Adjuvant! Online, 10,743 euros; and the mean cost of systematic chemotherapy, 12,123 euros. Over the 10-year follow-up period, there were no differences in life-years or quality-adjusted life-years.

Treatment de-escalation is critical for ensuring high-quality survivorship over the long term, wrote Dr. Bonastre of Gustave Roussy Institute of Oncology, Paris, and her associates. “However, our study shows that the health benefits associated with the use of molecular tests are modest. In addition, the high price of these tests results in poor value for the money, limiting their usefulness in routine practice,” they said.

The study was funded by the French National Cancer Institute, and the authors reported no conflicts of interest.

msullivan@frontlinemedcom.com

On Twitter @alz_gal

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Genetic screen not worth cost for node-negative breast cancer patients
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FROM THE JOURNAL OF CLINICAL ONCOLOGY

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Key clinical point: A 70-gene signature screen for chemotherapy guidance for node-negative breast cancer patients did not lead to better outcomes compared with a free online tool or giving all patients chemotherapy.

Major finding: The mean cost of the 70-gene MammaPrint profile was 12,870 euros; the mean cost of Adjuvant! Online, 10,743 euros; and the mean cost of systematic chemotherapy, 12,123 euros, with no differences in life-years with 10 years of follow-up.

Data source: The mixed-model analysis comprised 307 patients who took part in a MammaPrint validation study.

Disclosures: The study was funded by the French National Cancer Institute, and the authors reported no conflicts of interest.