AR-V7 as a Biomarker for Resistance to Treatment with Abiraterone/Enzalutamide in Three Latin American Countries: A Hypothetical Cost-Saving Analysis
Por:
Pacheco-Orozco R.A., Montealegre-Páez L., Cayol F., Martínez-Gregorio H., Oliver J., Frecha C., Vaca-Paniagua F., Perdomo S.
Publicada:
1 dic 2020
Ahead of Print:
1 ene 2020
Resumen:
Background: Prostate cancer is the most incident and one of the deadliest male cancers in Latin America. Treatment for patients with metastatic castration-resistant prostate cancer (mCRPC) includes androgen receptor signaling inhibitors such as abiraterone and enzalutamide, for which androgen receptor splice variant 7 (AR-V7) has emerged as a biomarker for primary resistance. Our study sought to analyze the potential economic impact of the use of AR-V7 detection as a treatment indicator in patients with mCRPC in three Latin American countries. Materials and Methods: A hypothetical cost prediction model for the use of noninvasive circulating tumor cell–based AR-V7 testing as a treatment indicator for patients eligible for treatment with abiraterone/enzalutamide was conducted using available information on treatment and testing costs from Mexico, Argentina, and Colombia. Results: At an estimated prevalence of AR-V7 positivity of 20%, the use of upfront AR-V7 genetic testing resulted in annual net savings of $9,801,669.97, $6,390,055.75, and $3,096,780.91 in Mexico, Argentina, and Colombia, respectively. A direct relationship between AR-V7 positivity prevalence and net savings was found. Conclusion: The use of a noninvasive AR-V7 detection assay as a treatment indicator tool in patients eligible for treatment with abiraterone or enzalutamide in Latin America could be a cost-effective approach for the management of these patients. Additional efforts are needed to accurately determine the incidence of castration-resistant prostate cancer cases and the prevalence of AR-V7 positivity in Latin America in order to predict the potential economic benefit of its clinical use. Implications for Practice: In Latin America, prostate cancer is the most frequently diagnosed cancer in men, and the burden of this disease is expected to double in this region by 2030. Noninvasive detection of androgen receptor splice variant 7 (AR-V7) is being currently validated as a predictive biomarker for benefit with androgen receptor signaling inhibitor therapy in patients with metastatic castration-resistant prostate cancer (mCRPC). This hypothetical cost-saving analysis shows that AR-V7 testing in peripheral blood of patients with CRPC eligible for treatment with abiraterone or enzalutamide might represent a cost-effective strategy to select patients who will benefit from AR-axis–directed treatment in three Latin American countries. © 2020 The Authors. The Oncologist published by Wiley Periodicals LLC on behalf of AlphaMed Press.
Filiaciones:
Pacheco-Orozco R.A.:
Instituto de Investigación en Nutrición, Genética y Metabolismo, Facultad de Medicina, Universidad el Bosque, Bogotá, Colombia
Montealegre-Páez L.:
Instituto de Investigación en Nutrición, Genética y Metabolismo, Facultad de Medicina, Universidad el Bosque, Bogotá, Colombia
Cayol F.:
Sección de Oncología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
Martínez-Gregorio H.:
Laboratorio Nacional en Salud: Diagnóstico Molecular y Efecto Ambiental en Enfermedades Crónico-Degenerativas, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, México City, Mexico
Oliver J.:
Instituto de Medicina Traslacional e Ingeniería Biomédica, Instituto Universitario Hospital Italiano, Buenos Aires, Argentina
Medical Oncology Service, Hospitales Universitarios Regional y Virgen de la Victoria, Institute of Biomedical Research in Málaga (IBIMA), CIMES, University of Málaga, Málaga, Spain
Frecha C.:
Instituto de Medicina Traslacional e Ingeniería Biomédica, Instituto Universitario Hospital Italiano, Buenos Aires, Argentina
Consejo Nacional de Investigaciones Científicas y Técnicas CONICET, Buenos Aires, Argentina
Vaca-Paniagua F.:
Laboratorio Nacional en Salud: Diagnóstico Molecular y Efecto Ambiental en Enfermedades Crónico-Degenerativas, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, México City, Mexico
Unidad de Biomedicina, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Mexico
Subdirección de Investigación Básica, Instituto Nacional de Cancerología, Mexico
Perdomo S.:
Instituto de Investigación en Nutrición, Genética y Metabolismo, Facultad de Medicina, Universidad el Bosque, Bogotá, Colombia
Genetic Epidemiology Group, International Agency for Research in Cancer, Lyon, France
All Open Access; Hybrid Gold
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