Abstract
Aims: EGFR and ALK analysis is routinely undertaken prior to targeted treatment of non-squamous non-small cell lung carcinoma (NSCLC). Increasingly limited resources require molecular pathology services to be cost effective without detriment to patient care.
Methods: Data from an audit of molecular pathology testing in the South East of Scotland Cancer network has been used to explore different testing strategies with the aim of reducing costs; including investigation of TTF1 expression as a negative predictor for EGFR mutations.
Results: TTF1 immunohistochemistry had a high negative predictive value for EGFR mutations (99%). Reflex testing all non-squamous NSCLC had the highest costs whereas limiting testing to those who might be considered for treatment would save 7.5%; the serial model could save 32.7%.
Conclusions: Testing only patients being considered for EGFR and ALK inhibitors represented small savings; more significant savings would be achievable if testing algorithms utilized known associations between clinical biomarkers.
Methods: Data from an audit of molecular pathology testing in the South East of Scotland Cancer network has been used to explore different testing strategies with the aim of reducing costs; including investigation of TTF1 expression as a negative predictor for EGFR mutations.
Results: TTF1 immunohistochemistry had a high negative predictive value for EGFR mutations (99%). Reflex testing all non-squamous NSCLC had the highest costs whereas limiting testing to those who might be considered for treatment would save 7.5%; the serial model could save 32.7%.
Conclusions: Testing only patients being considered for EGFR and ALK inhibitors represented small savings; more significant savings would be achievable if testing algorithms utilized known associations between clinical biomarkers.
| Original language | English |
|---|---|
| Pages (from-to) | 938-941 |
| Journal | Journal of Clinical Pathology |
| Volume | 69 |
| Issue number | 10 |
| Early online date | 7 Jul 2016 |
| DOIs | |
| Publication status | Published - Oct 2016 |
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- Costings and audit paper
© 2016, the Author(s). This work is made available online in accordance with the publisher’s policies. This is the author created, accepted version manuscript following peer review and may differ slightly from the final published version. The final published version of this work is available at jcp.bmj.com / https://dx.doi.org/10.1136/jclinpath-2016-203863