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Article Dans Une Revue HemaSphere Année : 2023

Targeted High-throughput Sequencing for Hematological Malignancies: A GBMHM Survey of Practice and Cost Evaluation in France

Meryl Darlington
  • Fonction : Auteur
Pierre Sujobert
Olivier Kosmider
  • Fonction : Auteur
Damien Luque Paz
Sophie Kaltenbach
  • Fonction : Auteur
Sandrine Hayette
  • Fonction : Auteur
Nadia Mezaour
  • Fonction : Auteur
Séverine Coquerelle
  • Fonction : Auteur
Anne-Sophie Alary
  • Fonction : Auteur
Audrey Bidet
  • Fonction : Auteur
Yannick Le Bris
  • Fonction : Auteur
Eric Delabesse
  • Fonction : Auteur
Frédéric Davi
  • Fonction : Auteur
Claude Preudhomme
  • Fonction : Auteur
Isabelle Durand-Zaleski
  • Fonction : Auteur
Elizabeth Macintyre
  • Fonction : Auteur

Résumé

The objective of this study was to assess the clinical impact and financial costs of next-generation sequencing (NGS) in 5 categories of pediatric and adult hematological cancers. NGS prescriptions were prospectively collected from 26 laboratories, with varied technical and reporting practice (all or only significant targets). Impact was defined by the identification of (1) an actionable mutation, (2) a mutation with prognostic and/or theranostic value, and/or (3) a mutation allowing nosological refinement, reported by local investigators. A microcosting study was undertaken in 4 laboratories, identifying the types and volumes of resources required for each procedural step. Individual index prescriptions for 3961 patients were available for impact analysis on the management of myeloid disorders (two thirds) and, mainly mature B, lymphoid disorders (one third). NGS results were considered to impact the management for 73.4% of prescriptions: useful for evaluation of prognostic risk in 34.9% and necessary for treatment adaptation (actionable) in 19.6%, but having no immediate individual therapeutic impact in 18.9%. The average overall cost per sample was 191 € for the restricted mature lymphoid amplicon panel. Capture panel costs varied from 369 € to 513 €. Unit costs varied from 0.5 € to 5.7 € per kb sequenced, from 3.6 € to 11.3 € per target gene/hot-spot sequenced and from 4.3 € to 73.8 € per target gene/hot-spot reported. Comparable costs for the Amplicon panels were 5–8 € per kb and 10.5–14.7 € per target gene/hot-spot sequenced and reported, demonstrating comparable costs with greater informativity/flexibility for capture strategies. Sustainable funding of precision medicine requires a transparent discussion of its impact on care pathways and its financial aspects.
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Dates et versions

hal-04414131 , version 1 (24-01-2024)

Identifiants

  • HAL Id : hal-04414131 , version 1

Citer

Meryl Darlington, Pierre Sujobert, Olivier Kosmider, Damien Luque Paz, Sophie Kaltenbach, et al.. Targeted High-throughput Sequencing for Hematological Malignancies: A GBMHM Survey of Practice and Cost Evaluation in France. HemaSphere, 2023, 7 (9), pp.e943. ⟨hal-04414131⟩
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