Biomarkers Could Help Lower Treatment Costs, Side Effects

Before Matt Ellefson’s non-small cell lung cancer was tested for a biomarker that allowed a single drug to keep it under control, the 51-year-old South Dakota resident underwent standard chemotherapy and radiation treatments that came with typical side effects.

Worst among them were pain from radiation burns near his esophagus and two incidences of radiation-induced pneumonitis (a lung inflammation) that required lengthy hospitalizations.

But in the two years Ellefson has taken Xalkori (crizotinib), a targeted drug inhibiting a cancer-fueling protein expressed by his ALK gene mutation, he has dealt with only one noteworthy side effect—low testosterone levels affecting his energy, which he alleviates with a topical testosterone cream.

In addition to improving the effectiveness of cancer treatments, biomarkers have the potential to help patients avoid burdensome side effects and save money on costly therapies to which a cancer won’t respond. In the journal Personalized Medicine, experts suggest that biomarker use could lower the overall cost of cancer care in the U.S., where health care accounts for nearly onefifth of the gross domestic product.

Without the benefit of biomarker tests for cancer patients, “we tend to overtreat rather than undertreat,” says Daniel Hayes, a professor of medicine and breast cancer research at the University of Michigan in Ann Arbor. “A really good biomarker test is good for the patient and the insurance company. In theory, that’s going to save lots of patients lots of toxicity and lots of third-party payers lots of money.”

But, Hayes adds, for a biomarker test to be valuable, doctors must have “tremendous confidence” in its analytical validity and clinical utility. “It must be shown with high levels of evidence that using the test improves the patient’s outcome.”