Update from the 2009 Gastrointestinal Cancer Symposium
Over half a billion dollars could potentially be saved if all patients with colorectal cancer that had spread were tested for the KRAS gene before beginning treatment.
Because patients with mutated KRAS in their tumors don’t benefit from treatment with EGFR inhibitors Erbitux® (cetuximab) and Vectibix™ (panitumumab), offering them those drugs is a futile expense. In addition, trying the drugs delays potentially effective treatment and exposes patients to skin rash and other unnecessary side effects.
Nearly 30,000 people will be diagnosed with metastatic colorectal cancer in the United States each year. About a third will have a mutation in the KRAS gene in their tumors. Upfront testing of all patients at $452 each would cost $13 million. Assuming, based on information from clinical trials, that the average patient would receive 24 treatments , the cost of Erbitux for each patient would be $71,120.
Not treating patients with KRAS mutations would save $617 million in drug costs. Subtracting the cost of testing, net health care cost savings would be $604 million.
Of course, not all patients would receive EGFR inhibitor drugs as initial treatment. Frequently, Erbitux or Vectibix is given after cancer has already progressed on other treatments. Still, given a cost of $3,986 for the first week’s Erbitux treatment and $2,491 each week thereafter, a test costing less than $500 would still save significant dollars.
SOURCE: Shankaran et al., 2009 ASCO GI Symposium, Abstract 298.