Characteristics of Patients With Minimal Residual Disease (MRD) Testing for Solid Tumors in a United States Population With Commercial or Medicare Advantage (MA) Insurance
Moderator
Jamie Tucker, BA, MS, Optum, Eden Prarie, MN, United States
Speakers
Karen Stockl, MS, PharmD, Optum, Laguna Niguel, CA, United States; Pamela Morin; Laura Becker, MS; Laura Simmer; William Brady DeHart, PhD; Stacey DaCosta Byfield, MPH, PhD
OBJECTIVES: Liquid biopsy testing for MRD is an emerging technology for patients with solid tumors. Potential intended uses include surveillance for cancer progression and evaluation of response to therapy ahead of standard monitoring. This analysis aimed to evaluate patient characteristics and cancer types of patients with solid tumors who received MRD testing.
METHODS: Using de-identified administrative claims data for commercially insured and MA enrollees in the Optum Labs Data Warehouse, MRD tests were identified with CPT codes and unique identifier test codes submitted on claims. Patients ≥18y were included if they had ≥1 claim for a MRD test with a primary diagnosis code for a malignant solid tumor (ICD-10 C00*-C76*) between 01/01/2021 and 06/30/2023 plus 360 days baseline continuous enrollment. Cancer type from the primary ICD-10 code on the first MRD claim was categorized as colorectal (C18*, C19*, C20*), breast (C50*), lung (C34*), bladder (C67*), or other (all other solid tumor diagnoses). Evidence of metastasis was identified by ≥1 claim with ICD-10 code C77*-C80.0 in the 360-day baseline period.
RESULTS: Overall, 3,728 patients (11.2% commercial, 88.8% MA, 54.8% female, median age 72y) were identified. Cancer type distribution was 50.9% colorectal, 14.8% breast, 6.3% lung, 3.3% bladder, and 24.7% other; highest frequency other cancers were melanoma (3.3%), pancreatic (2.9%), and uterine (2.1%). Evidence of metastasis was found in 48.9% of patients overall, and by cancer type 46.0% of colorectal, 42.6% of breast, 52.4% of lung, 48.4% of bladder, and 58.0% of other cancers.
CONCLUSIONS: In this nationwide sample with commercial or MA insurance, the most frequent solid tumors for MRD testing were colorectal, breast, and lung. Nearly one-half of patients had diagnosis codes indicating metastasis. Further analyses are needed to examine real-world MRD utilization and treatment patterns within each solid tumor type and by intended use setting (adjuvant post-surgical, recurrence surveillance, or immunotherapy response monitoring).
METHODS: Using de-identified administrative claims data for commercially insured and MA enrollees in the Optum Labs Data Warehouse, MRD tests were identified with CPT codes and unique identifier test codes submitted on claims. Patients ≥18y were included if they had ≥1 claim for a MRD test with a primary diagnosis code for a malignant solid tumor (ICD-10 C00*-C76*) between 01/01/2021 and 06/30/2023 plus 360 days baseline continuous enrollment. Cancer type from the primary ICD-10 code on the first MRD claim was categorized as colorectal (C18*, C19*, C20*), breast (C50*), lung (C34*), bladder (C67*), or other (all other solid tumor diagnoses). Evidence of metastasis was identified by ≥1 claim with ICD-10 code C77*-C80.0 in the 360-day baseline period.
RESULTS: Overall, 3,728 patients (11.2% commercial, 88.8% MA, 54.8% female, median age 72y) were identified. Cancer type distribution was 50.9% colorectal, 14.8% breast, 6.3% lung, 3.3% bladder, and 24.7% other; highest frequency other cancers were melanoma (3.3%), pancreatic (2.9%), and uterine (2.1%). Evidence of metastasis was found in 48.9% of patients overall, and by cancer type 46.0% of colorectal, 42.6% of breast, 52.4% of lung, 48.4% of bladder, and 58.0% of other cancers.
CONCLUSIONS: In this nationwide sample with commercial or MA insurance, the most frequent solid tumors for MRD testing were colorectal, breast, and lung. Nearly one-half of patients had diagnosis codes indicating metastasis. Further analyses are needed to examine real-world MRD utilization and treatment patterns within each solid tumor type and by intended use setting (adjuvant post-surgical, recurrence surveillance, or immunotherapy response monitoring).
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
RWD15
Topic
Real World Data & Information Systems
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Oncology