FRIDAY, Jan. 16 (HealthDay News) -- Universal KRAS testing of metastatic colorectal cancer patients to identify tumors that do not respond to cetuximab could save more than $600 million a year in unnecessary treatment costs, according to research presented at the sixth annual Gastrointestinal Cancers Symposium held Jan. 15 to 17 in San Francisco.
Based on the American Cancer Society's 2008 estimate of 28,724 metastatic colorectal cancer cases, Veena Shankaran, M.D., of Northwestern University in Chicago, and colleagues found that KRAS testing would cost about $452 per patient and that a 24-dose course of cetuximub would cost about $61,279 per patient. Using a conservative estimate that 35.6 percent of tumors have KRAS mutations that do not respond to cetuximab, the researchers projected that treating only patients with normal KRAS would save $617 million a year, resulting in a net savings of $604 million a year after subtracting the costs of KRAS testing.
In a related development, the American Society of Clinical Oncology (ASCO) released its first Provisional Clinical Opinion on the use of KRAS gene mutation testing in patients with metastatic colorectal cancer, and recommended testing for all such patients who are candidates for anti-EFGR therapy. In patients with a mutated form of the KRAS gene, the society recommended against the use of anti-EFGR antibody therapy.
"To our knowledge, this is the first analysis to demonstrate cost savings by customizing therapy in a gastrointestinal malignancy using a molecular test. Though cetuximab is used more commonly in second- and third-line therapy where treatment duration is shorter, Kras-based treatment selection is likely to result in cost savings across all lines of therapy," Shankaran and colleagues conclude.
The research team disclosed financial support from ImClone Systems Incorporated.
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