Impact of the 92-gene assay on cost of diagnosis of tumor type in metastatic cancer of uncertain origin.

e15104 Background: Molecular classification of tumors has been incorporated into clinical algorithms for patients with metastatic cancers of uncertain origin. This study is a comprehensive cost analysis—characterizing standard of care for metastatic disease, cost implications of correct vs incorrect diagnosis, and cost effectiveness of implementing molecular classification into the diagnostic paradigm. Methods: A deterministic model was developed to project the cost and effectiveness of standard care for metastatic tumors of uncertain origin, compared with incorporating use of the 92-gene assay at 3 points: before immunohistochemical (IHC) analysis, or after 1, or 2 sets of IHC stains. For each strategy, total and incremental costs, life-years (LYs), quality-adjusted life years (QALYs), and incremental cost effectiveness ratios (ICERs) were projected, as well as the % of patients treated correctly vs incorrectly. Model inputs and costs were based on published literature, analyses of the SEER database, the...