OBJECTIVES: To conduct a cost-effectiveness analysis (CEA) to compare a large next-generation sequencing (NGS) panel (FOne panel, 324 genes) versus a 87 gene home-based NGS panel (CTRL) in cancer patients (pts).

METHODS: The CEA was designed as part of the multicenter, randomized, prospective Profiler02 clinical trial. Pts with advanced/metastatic solid tumors without known targetable gene alteration were randomized during their 1st or 2nd metastatic line of treatment. Both panels were performed for each patients, the randomization arm defined the first panel to be reviewed by the dedicated molecular tumor board (MTB) at time of progression while the 2nd panel remained blinded. Costs (€2020) were assessed from the French National Health perspective (limited to expenditures in cancer centres and teaching hospitals) until 12 months after initiation of a new anti-cancer therapy. Pts consumptions were provided by local hospital Discharge database. Incremental cost-effectiveness ratios (ICERs) were expressed in cost per life year gained and in cost per % of pts for which a molecularly-targeted therapy was initiated. Probabilistic analyses were performed.

RESULTS: Among the 339 randomized pts, 163 (79 for Fone and 84 for CTRL) were eligible for economic analysis (failure of molecular analysis n=18, death before MTB n=58, no new treatment line delivered post-MTB#1 n=100). Based on preliminary data, the mean total cost was €20,793 (±11,439) for FOne panel versus €18,849 (± 17,972) for CTRL panel. ICERs were €102 893 per life year gained and €20 678 per % of pts for which a molecularly-targeted therapy was initiated. The probability of the ICER belonging to each quadrant of the cost-effectiveness plane was the highest for the Northeast quadrant for which the Fone was both more costly and more effective.

CONCLUSIONS: Additional evaluations will be performed using the National Health Data System (SNDS), with longer time horizon, and QALY calculation.