title: Clinical and economic aspects of KRAS mutational status as predictor for epidermal growth factor receptor inhibitor therapy in metastatic colorectal cancer patients.
abstract: Treatment of metastasized colorectal cancer (mCRC) patients with anti-epidermal growth factor receptor (EGFR)-directed monoclonal antibodies is driven by the results of the KRAS mutational status (wild type [WT]/mutated [MUT]). To find out as to what extent the treatment selection based on the KRAS status had impact on overall costs, a retrospective analysis was performed. Of 73 mCRC patients 31.5% were MUT carriers. Costs of EGFR inhibitor treatment for WT patients were significantly higher compared to those for patients with MUT (p = 0.005). Higher treatment costs in WT carriers reflect a significantly higher number of treatment cycles (p = 0.012) in this cohort of patients. Savings of drug costs minus the costs for the determination of KRAS status accounted for EUR 779.42 (SD ±336.28) per patient per cycle. The routine use of KRAS screening is a cost-effective strategy. Costs of unnecessary monoclonal EGFR inhibitor treatment can be saved in MUT patients.
authors.affiliation: Ludwig Boltzmann Institute for Applied Cancer Research (LBI-ACR VIEnna), LB Cluster Translational Oncology, 3rd Medical Department, Centre for Oncology and Haematology, Kaiser Franz Josef-Spital, Vienna, Austria. robert.koenigsberg@gmx.at
authors.forename: Robert
authors.initials: R
authors.lastname: Königsberg
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Hulla
authors.forename: Martin
authors.initials: M
authors.lastname: Klimpfinger
authors.forename: Angelika
authors.initials: A
authors.lastname: Reiner-Concin
authors.forename: Tanja
authors.initials: T
authors.lastname: Steininger
authors.forename: Wilfried
authors.initials: W
authors.lastname: Büchler
authors.forename: Robert
authors.initials: R
authors.lastname: Terkola
authors.forename: Christian
authors.initials: C
authors.lastname: Dittrich
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal / Q000191:economics / Q000627:therapeutic use; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000191:economics* / Q000235:genetics / Q000473:pathology; D003362:Cost-Benefit Analysis / Q000379:methods; D055088:Early Detection of Cancer / Q000191:economics* / Q000379:methods; D066246:ErbB Receptors / Q000037:antagonists & inhibitors* / Q000191:economics; D005260:Female; D011905:Genes, ras; D006801:Humans; D008297:Male; D008875:Middle Aged; D009154:Mutation; D009362:Neoplasm Metastasis; D011237:Predictive Value of Tests; D047428:Protein Kinase Inhibitors / Q000191:economics / Q000627:therapeutic use*; D011518:Proto-Oncogene Proteins / Q000191:economics / Q000235:genetics; D016283:Proto-Oncogene Proteins p21(ras); D012189:Retrospective Studies; D018631:ras Proteins / Q000191:economics / Q000235:genetics
chemical_list: D000911:Antibodies, Monoclonal; C117307:KRAS protein, human; D047428:Protein Kinase Inhibitors; D011518:Proto-Oncogene Proteins; D066246:ErbB Receptors; D016283:Proto-Oncogene Proteins p21(ras); D018631:ras Proteins