Humana Healthcare Research Inc, Louisville, KY.
Genentech Inc, South San Francisco, CA.
JCO Precis Oncol. 2021 May 5;5. doi: 10.1200/PO.20.00422. eCollection 2021.
To develop an approach to identify and evaluate recent use of multigene panel testing over time.
We conducted a retrospective database analysis using medical and pharmacy claims data. Medicare Advantage Prescription Drug Plan members diagnosed with select malignant solid tumors were identified. The pattern of somatic genetic testing for each patient was evaluated from January 2016 through December 2018. Tests were classified by the number of genes tested in the panel: < 50 (small or medium) and ≥ 50 (large).
An initial feasibility study using our novel approach for identifying panel tests resulted in 2.4 and 1.2 times more large and medium panels, respectively, identified compared with using procedure codes alone. A total of 121,675 eligible patients were identified, with 131,915 unique cancer cases. Overall, 5,457 (4.5%) patients received any panel test from 2016 to 2018. We found the number of tests performed each quarter increased from 238 in Q1 of 2016 to 755 in Q4 of 2018. The highest number of cases were genitourinary cancers; however, the highest proportion of cancer-related genetic testing was among patients with respiratory cancer. Across all tumor types, the proportion of large-panel tests performed as a function of all multigene panel tests increased from 20.7% of tests in Q1 of 2016 to 46.4% of tests in Q4 of 2018. The three cancer categories with the highest count of cancer-related panel tests, respiratory cancer, GI cancer, and female reproductive cancer, had a consistently greater proportion receiving a panel test at any point postindex.
Across a variety of cancers, use of somatic, large-panel cancer-related genetic testing, as a proportion of all somatic cancer-related genetic testing, increased from 2016 to 2018, although testing overall was low.
开发一种方法来识别和评估随时间推移多基因面板检测的近期使用情况。
我们使用医疗和药房索赔数据进行了回顾性数据库分析。确定了在选定的恶性实体瘤中诊断出的医疗保险优势处方药计划成员。从 2016 年 1 月到 2018 年 12 月，评估了每位患者的体细胞遗传检测模式。根据面板中检测的基因数量对测试进行分类：<50（小或中）和≥50（大）。
使用我们用于识别面板测试的新方法进行的初步可行性研究导致分别确定了大面板和中面板的数量增加了 2.4 倍和 1.2 倍，而单独使用程序代码则分别增加了 2.4 倍和 1.2 倍。确定了 121,675 名合格患者，有 131,915 个独特的癌症病例。总体而言，2016 年至 2018 年间，有 5,457（4.5%）名患者接受了任何面板测试。我们发现，每个季度进行的测试数量从 2016 年第一季度的 238 个增加到 2018 年第四季度的 755 个。病例数量最多的是泌尿生殖系统癌症；然而，与呼吸癌症相关的遗传检测比例最高。在所有肿瘤类型中，大面板测试作为所有多基因面板测试的一部分的比例从 2016 年第一季度的测试的 20.7%增加到 2018 年第四季度的测试的 46.4%。与癌症相关的面板测试数量最高的三个癌症类别（呼吸癌、胃肠道癌和女性生殖系统癌）在指数后任何时候接受面板测试的比例始终更高。
在各种癌症中，作为所有与癌症相关的体细胞遗传测试的一部分，大面板的体细胞遗传检测的使用比例从 2016 年到 2018 年有所增加，尽管总体测试数量较低。
