Molecular Testing in Primary Advanced or Recurrent Endometrial Cancer: A Cost-Effectiveness Analysis.
Summary
This study assessed the cost-effectiveness of ProMisE (Proactive Molecular Risk Classifier for Endometrial Cancer) testing to guide initial treatment in stage III/IV primary advanced or recurrent endometrial cancer. Using a decision tree and partitioned survival model, researchers compared lifetime costs and outcomes with and without molecular testing. The findings indicate that ProMisE testing is cost-effective from a payer perspective, with an incremental cost-effectiveness ratio (ICER) of $66,321 USD per quality-adjusted life-year (QALY) gained, well below the $150,000 USD threshold. From a societal perspective, ProMisE testing even resulted in lower costs and higher QALYs. This personalized approach is considered clinically meaningful and of high value.
Analysis
Clinique : This cost-effectiveness analysis, based on results from clinical trials like RUBY, suggests that ProMisE testing is a highly valuable predictive biomarker for advanced or recurrent endometrial cancer. With an ICER of $66,321 USD per QALY gained, it is considered very cost-effective against a $150,000 USD threshold. Integrating this test could justify changes in treatment guidelines to allow for a more personalized approach, potentially improving patient life-years and QALYs. Clinical impact could be seen in the medium term (3-5 years) if these findings are widely adopted. Biomol : The ProMisE test represents a significant translational advance by enabling proactive molecular classification of endometrial cancer. While specific techniques are not detailed, it functions as a risk classifier that leverages the heterogeneity of molecular subtypes to guide treatments. This precision medicine approach, based on biomarkers, allows for tailoring therapies (chemotherapy, immunotherapy, hormone therapy, anti-angiogenic agents) to patients' molecular profiles, thereby optimizing clinical outcomes.