Clinical practice patterns and cost effectiveness of human epidermal growth receptor 2 testing strategies in breast cancer patients.
Clinical practice patterns and cost effectiveness of human epidermal growth receptor 2 testing strategies in breast cancer patients.
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DOI：
10.1002/cncr.24574
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发表时间：
2009-11-15
期刊：
影响因子：
6.2
通讯作者：
Van Bebber, Stephanie L.
中科院分区：
文献类型：
--
作者：
Phillips, Kathryn A.;Marshall, Deborah A.;Haas, Jennifer S.;Elkin, Elena B.;Liang, Su-Ying;Hassett, MichaelJ.;Ferrusi, Ilia;Brock, Jane E.;Van Bebber, Stephanie L.
关键词：
Testing technologies are increasingly used to target cancer therapies. Human epidermal growth factor receptor 2 (HER2) testing to target trastuzumab for patients with breast cancer provides insights into the evidence needed for emerging testing technologies. We reviewed literature on HER2 test utilization and cost-effectiveness of HER2 testing for patients with breast cancer. We examined available evidence on: percentage of eligible patients tested for HER2; test methods used; concordance of test results between community and central/reference laboratories; use of trastuzumab by HER2 test result; and cost-effectiveness of testing strategies. Little evidence is available to determine whether all eligible patients are tested; how many are retested to confirm results; and how many with negative HER2 test results still receive trastuzumab. Studies suggest that up to 66% of eligible patients had no documentation of testing in claims records; up to 20% of patients receiving trastuzumab were not tested or had no documentation of a positive test; and 20% of HER2 results may be incorrect. Few cost-effectiveness analyses of trastuzumab explicitly considered the economic implications of various testing strategies. There is little information about the actual use of HER2 testing in clinical practice, but evidence suggests important variations in testing practices and key gaps in knowledge exist. Given the increasing use of targeted therapies, it is critical to build an evidence base that supports informed decision-making on emerging testing technologies in cancer care.
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