Author of

• 18374

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  P3.02b - Poster Session with Presenters Present (ID 494)

  • Event: WCLC 2016
  • Type: Poster Presenters Present
  • Track: Advanced NSCLC
  • Presentations: 1
  • Moderators:
  • Coordinates: 12/07/2016, 14:30 - 15:45, Hall B (Poster Area)

  • 18395

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    P3.02b-021 - Comparing T790M Identification across Testing Strategies in Advanced EGFR NSCLC: A Diagnostic Outcomes and Cost Analysis (ID 4752)

    14:30 - 14:30  |  Author(s): M. Cheng
    • Abstract

    Background:
    T790M is an acquired mutation in patients (pts) with advanced non-small cell lung cancer (aNSCLC) treated with an EGFR TKI. The tumours of approximately 60% pts treated with an EGFR TKI harbour the T790M mutation upon disease progression. With the launch of treatments targeting T790M in EGFR aNSCLC it is important to identify pts with T790M who will benefit from such therapy. However not all pts are able to undergo tissue biopsy for testing and the advent of ctDNA testing via plasma sample may increase the number of pts with access to a T790M test. This analysis assesses outcomes and costs of different diagnostic testing strategies for T790M in aNSCLC post-EGFR TKI.
    
    Methods:
    Estimates of T790M mutation prevalence and test performance were applied to a hypothetical cohort of 100 pts. Outcomes were number of true positive / true negative (TP / TN) samples and associated testing costs. The following testing strategies were assessed: i) tissue test only ii) plasma followed by tissue for pts who tested negative using plasma or, iii) both tissue and plasma tests concurrently. Total costs were also estimated for the sample procedure (biopsy or plasma extraction), laboratory testing, and biopsy adverse events (5% rate).
    
    Results:
    In sequence or concurrent testing (strategies ii & iii) produced the highest number of TP results (n=57) followed by tissue test alone (n=53). Tissue & plasma concurrently (iii) was associated with the highest total costs followed by tissue test only (i) and the lowest cost plasma followed by tissue for pts who tested negative (ii).
    
    Conclusion:
    To maximise identification of T790M, and hence the most pts who would benefit from targeted therapy, access to both plasma and tissue testing is advantageous. Plasma followed by tissue for pts who tested negative may also be a cost minimising option for healthcare systems compared to tissue testing alone.