The potential survival gain and cost-effectiveness of circulating tumor DNA-guided treatment switching in advanced non-small cell lung cancer: A simulation modeling study.
OpenAlex 토픽 ·
Cancer Genomics and Diagnostics
Cancer Cells and Metastasis
Lung Cancer Treatments and Mutations
[OBJECTIVE] Circulating tumor DNA (ctDNA) has emerged as a minimally invasive approach to assess treatment response in cancer.
APA
Jeroen P. Jansen, Michael P. Douglas, Kathryn A. Phillips (2026). The potential survival gain and cost-effectiveness of circulating tumor DNA-guided treatment switching in advanced non-small cell lung cancer: A simulation modeling study.. The journal of liquid biopsy, 12, 100460. https://doi.org/10.1016/j.jlb.2026.100460
MLA
Jeroen P. Jansen, et al.. "The potential survival gain and cost-effectiveness of circulating tumor DNA-guided treatment switching in advanced non-small cell lung cancer: A simulation modeling study.." The journal of liquid biopsy, vol. 12, 2026, pp. 100460.
PMID
42004688
Abstract
[OBJECTIVE] Circulating tumor DNA (ctDNA) has emerged as a minimally invasive approach to assess treatment response in cancer. While ctDNA response has been associated with greater survival outcomes, the clinical benefit and economic value of using ctDNA to inform early treatment switching is unclear. The objective was to estimate the potential effectiveness and cost-effectiveness of ctDNA-guided treatment switching in advanced NSCLC.
[METHODS] We developed a semi-Markov model to estimate survival gains in weeks, incremental quality-adjusted life years (QALYs), incremental costs, and incremental cost-effectiveness ratios with ctDNA-guided treatment switching relative to standard of care (SOC). The model used survival parameters from the Prospective Clinico-Genomic study. We evaluated ctDNA testing at 6, 10, or 15 weeks post-treatment initiation, assuming varying degrees of improved efficacy with the subsequent treatment regimen with earlier switching (odds ratios 0.7-1.0).
[RESULTS] In the base-case scenario, assuming 10-week testing with 10% mortality reduction, ctDNA-guided switching yielded 4.0 weeks survival gain (95% uncertainty interval: -2.5, 10.9) at an additional cost of $3975 ($3,755, $4179), resulting in an incremental cost-effectiveness ratio of $87,941 per QALY. These findings suggest a 66% probability that ctDNA-guided therapy would be cost-effective at $150,000 per QALY. Earlier testing and stronger efficacy assumptions improved estimates, with survival gains ranging from 2.0 to 7.4 weeks across scenarios.
[CONCLUSIONS] ctDNA-guided treatment switching may provide modest survival benefits within accepted cost-effectiveness thresholds, though substantial uncertainty exists. The magnitude of clinical benefit and economic value depends on the timing of ctDNA assessment and the efficacy advantage conferred by earlier treatment switching.
[METHODS] We developed a semi-Markov model to estimate survival gains in weeks, incremental quality-adjusted life years (QALYs), incremental costs, and incremental cost-effectiveness ratios with ctDNA-guided treatment switching relative to standard of care (SOC). The model used survival parameters from the Prospective Clinico-Genomic study. We evaluated ctDNA testing at 6, 10, or 15 weeks post-treatment initiation, assuming varying degrees of improved efficacy with the subsequent treatment regimen with earlier switching (odds ratios 0.7-1.0).
[RESULTS] In the base-case scenario, assuming 10-week testing with 10% mortality reduction, ctDNA-guided switching yielded 4.0 weeks survival gain (95% uncertainty interval: -2.5, 10.9) at an additional cost of $3975 ($3,755, $4179), resulting in an incremental cost-effectiveness ratio of $87,941 per QALY. These findings suggest a 66% probability that ctDNA-guided therapy would be cost-effective at $150,000 per QALY. Earlier testing and stronger efficacy assumptions improved estimates, with survival gains ranging from 2.0 to 7.4 weeks across scenarios.
[CONCLUSIONS] ctDNA-guided treatment switching may provide modest survival benefits within accepted cost-effectiveness thresholds, though substantial uncertainty exists. The magnitude of clinical benefit and economic value depends on the timing of ctDNA assessment and the efficacy advantage conferred by earlier treatment switching.
같은 제1저자의 인용 많은 논문 (2)
- Combining Simulation Model-Based Outcomes With County-Level Data for Geographic Health Equity Impact Evaluations of New Interventions.
- The Health Inequality Impact of Darolutamide for Nonmetastatic Castration-Resistant Prostate Cancer in the United States: A Distributional Cost-Effectiveness Analysis.