美国基因组分类器检测局部前列腺癌的社会人口统计特征,医疗费用和治疗影响
James R Janopaul-Naylor1, Dattatraya Patil2, Shreyas Joshi2
1Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY.
JCO precision oncology
|August 20, 2025
概括
前列腺癌的基因组分类器 (GC) 在美国越来越多地使用,影响治疗决策. 实际数据显示,GC与积极监测/警等待 (AS/WW) 和特定治疗途径有关.
科学领域:
- 癌症学
- 基因组学
- 医疗服务研究
背景情况:
- 可用于前列腺癌预后的基于组织的基因组分类器 (GCs).
- GC可以为主动监测/警等待 (AS/WW) 或与雄激素剥夺疗法 (ADT) 进行放射治疗 (RT) 的决定提供指导.
研究的目的:
- 在前列腺癌管理中分析GC的实际利用.
- 评估GC使用与治疗模式的临床决策之间的关联.
主要方法:
- 对局部前列腺癌的美国商业和医疗保险索赔 (2013-2022) 进行了审查.
- 根据GC接收和类型,评估了GC利用趋势并比较了治疗选择 (AS/WW,RT与/无ADT,急性前列腺切除术,焦点治疗).
主要成果:
- 在8年内,GC的使用率从<1%增加到17%,平均成本为3,001美元.
- 较高的GC使用率与年轻年龄,更高的收入和高扣除保险相关.
- GC使用与AS/WW增加相关,与AS/WW相关的特定GC (瘤型DX,Prolaris,Decipher),根性前列腺切除和RT+ADT.
结论:
- 在前列腺癌的治疗中,基因组的使用率和成本趋势越来越高.
- GC使用与特定的治疗模式有关,包括更高的AS/WW可能性.
- 虽然前性试验正在进行中,但美国目前的采用表明GC正在影响临床管理决策.
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