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Next Generation Sequencing for the Detection of Actionable Mutations in Solid and Liquid Tumors

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Economic Evaluation of Comprehensive Genomic Profiling in an Advanced Solid Cancer Population.

Lucas F van Schaik^1,2, Brigitte Maes^3,4, Pieter-Jan Volders^3,4

¹Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, the Netherlands.

JAMA Network Open

|December 11, 2025

Summary

Comprehensive genomic profiling (CGP) costs €14,249 to match a treatment in advanced cancer patients. This study provides crucial economic evidence for healthcare decision-makers regarding CGP implementation.

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Area of Science:

Oncology
Genomics
Health Economics

Background:

Decreasing sequencing costs enable larger gene panels for comprehensive genomic profiling (CGP).
The health economic impact of implementing CGP in clinical practice remains largely uncertain.
Understanding the costs associated with CGP-based treatment recommendations is crucial for healthcare decision-making.

Purpose of the Study:

To evaluate the clinical implementation costs of CGP-based advice in a prospective cohort of advanced cancer patients.
To compare the economic impact of upfront CGP versus standard-of-care diagnostics.
To provide health economic evidence for CGP adoption.

Main Methods:

Economic evaluation of a prospective Belgian multicenter observational study (BALLETT).
Decision tree model to assess costs and outcomes over a diagnostic time horizon.
Inclusion of patients with advanced solid tumors (May 2021 - Oct 2023).

Main Results:

Mean diagnostic costs were €2147 per patient in the BALLETT cohort.
Actionable targets identified in 76% of patients, with molecular tumor board (MTB) recommendations in 65%.
The diagnostic cost to match a CGP-recommended treatment was €14,249, varying by tumor type.

Conclusions:

CGP implementation for advanced cancer patients incurs significant diagnostic costs to achieve matched treatments.
The study provides essential economic data to guide healthcare decision-makers on the cost-effectiveness of CGP.
Sensitivity analyses highlight the influence of diagnostic costs and MTB recommendation uptake on cost-consequence ratios.