Impact of Next Generation Sequencing on Clinical Practice in Oncology in France: Better Genetic Profiles for Patients Improve Access to Experimental Treatments

Séverine Coquerelle (), Meryl Darlington, Morgane Michel, Manon Durand, Isabelle Borget, Sandrine Baffert, Patricia Marino (), Lionel Perrier and Isabelle Durand-Zaleski
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Séverine Coquerelle: URC Eco - Unité de recherche clinique en économie de la santé d'Ile-de-France - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP) - Hôtel-Dieu, CRESS (U1153 / UMR_A 1125) - Centre for Research in Epidemiology and Statistics | Centre de Recherche Épidémiologie et Statistiques - USPC - Université Sorbonne Paris Cité - INSERM - Institut National de la Santé et de la Recherche Médicale - UPCité - Université Paris Cité - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement
Meryl Darlington: URC Eco - Unité de recherche clinique en économie de la santé d'Ile-de-France - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP) - Hôtel-Dieu
Morgane Michel: URC Eco - Unité de recherche clinique en économie de la santé d'Ile-de-France - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP) - Hôtel-Dieu, ECEVE (U1123 / UMR_S_1123) - Epidémiologie Clinique et Evaluation Economique Appliquées aux Populations Vulnérables - INSERM - Institut National de la Santé et de la Recherche Médicale - AP-HP Hôpital universitaire Robert-Debré [Paris] - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP) - UPCité - Université Paris Cité
Manon Durand: URC Eco - Unité de recherche clinique en économie de la santé d'Ile-de-France - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP) - Hôtel-Dieu
Isabelle Borget: Etudes et Recherche en économie de la santé - SBE - Service de biostatistique et d'épidémiologie - Direction de la recherche clinique [Gustave Roussy] - IGR - Institut Gustave Roussy
Sandrine Baffert: CHU Rothschild [AP-HP] - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP) - SU - Sorbonne Université
Patricia Marino: SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD - Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale - IRD - Institut de Recherche pour le Développement - AMU - Aix Marseille Université - INSERM - Institut National de la Santé et de la Recherche Médicale
Isabelle Durand-Zaleski: URC Eco - Unité de recherche clinique en économie de la santé d'Ile-de-France - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP) - Hôtel-Dieu, CRESS (U1153 / UMR_A 1125) - Centre for Research in Epidemiology and Statistics | Centre de Recherche Épidémiologie et Statistiques - USPC - Université Sorbonne Paris Cité - INSERM - Institut National de la Santé et de la Recherche Médicale - UPCité - Université Paris Cité - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement, Hôpital Henri Mondor - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP) - Hôpital Henri Mondor - UPEC UP12 - Université Paris-Est Créteil Val-de-Marne - Paris 12

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Abstract: Objectives: We evaluated how next generation sequencing (NGS) can modify care pathways in an observational impact study in France.Methods: All patients with lung cancer, colorectal cancer, or melanoma who had NGS analyses of somatic genomic alterations done in 1 of 7 biomolecular platforms certified by the French National Cancer Institute (INCa) between 2013 and 2016 were eligible. We compared patients' pathways before and after their NGS results. Endpoints consisted of the turnaround time in obtaining results, the number of patients with at least 1 genomic alteration identified, the number of actionable alterations, the impact of the genomic multidisciplinary tumor board on care pathways, the number of changes in the treatment plan, and the survival outcome up to 1 year after NGS analyses.Results: 1213 patients with a request for NGS analysis were included. NGS was performed for 1155 patients, identified at least 1 genomic alteration for 867 (75%), and provided an actionable alteration for 614 (53%). Turnaround time between analyses and results was on average 8 days (Min: 0; Max: 95) for all cancer types. Before NGS analysis, 33 of 614 patients (5%) were prescribed a targeted therapy compared with 54 of 614 patients (8%) after NGS analysis. Proposition of inclusion in clinical trials with experimental treatments increased from 5% (n = 31 of 614) before to 28% (n = 178 of 614) after NGS analysis. Patients who benefited from a genotype matched treatment after NGS analysis tended to have a better survival outcome at 1 year than patients with nonmatched treatment: 258 days (±107) compared with 234 days (±106), (P = .41).Conclusions: NGS analyses resulted in a change in patients' care pathways for 20% of patients (n = 232 of 1155).

Keywords: NGS; clinical practice; oncology; somatic alterations. (search for similar items in EconPapers)
Date: 2020
Note: View the original document on HAL open archive server: https://shs.hal.science/halshs-02983051v1
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Published in Value in Health : the journal of the International Society for Pharmacoeconomics and Outcomes Research, 2020, 23 (7), pp. 898-906. ⟨10.1016/j.jval.2020.03.005⟩

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Persistent link: https://EconPapers.repec.org/RePEc:hal:journl:halshs-02983051

DOI: 10.1016/j.jval.2020.03.005

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