STK11
Serine/threonine-protein kinase STK11 precursor (EC 2.7.11.1) (Liver kinase B1) (LKB1) (hLKB1) (Renal carcinoma antigen NY-REN-19) [LKB1] [PJS]
Publications[править]
The National Comprehensive Cancer Network recommends that women who carry gene variants that confer substantial risk for breast cancer consider risk-reduction strategies, that is, enhanced surveillance (breast magnetic resonance imaging and mammography) or prophylactic surgery. Pathogenic variants can be detected in women with a family history of breast or ovarian cancer syndromes by multigene panel testing. To investigate whether using a seven-gene test to identify women who should consider risk-reduction strategies could cost-effectively increase life expectancy. We estimated effectiveness and lifetime costs from a payer perspective for two strategies in two hypothetical cohorts of women (40-year-old and 50-year-old cohorts) who meet the National Comprehensive Cancer Network-defined family history criteria for multigene testing. The two strategies were the usual test strategy for variants in BRCA1 and BRCA2 and the seven-gene test strategy for variants in BRCA1, BRCA2, TP53, PTEN, CDH1, STK11, and PALB2. Women found to have a pathogenic variant were assumed to undergo either prophylactic surgery or enhanced surveillance. The incremental cost-effectiveness ratio for the seven-gene test strategy compared with the BRCA1/2 test strategy was $42,067 per life-year gained or $69,920 per quality-adjusted life-year gained for the 50-year-old cohort and $23,734 per life-year gained or $48,328 per quality-adjusted life-year gained for the 40-year-old cohort. In probabilistic sensitivity analysis, the seven-gene test strategy cost less than $100,000 per life-year gained in 95.7% of the trials for the 50-year-old cohort. Testing seven breast cancer-associated genes, followed by risk-reduction management, could cost-effectively improve life expectancy for women at risk of hereditary breast cancer.
MeSH Terms
- Adult
- Age Factors
- Aged
- Aged, 80 and over
- Biomarkers, Tumor
- Breast Neoplasms
- Cost-Benefit Analysis
- Decision Support Techniques
- Early Detection of Cancer
- Female
- Gene Expression Profiling
- Genetic Predisposition to Disease
- Genetic Testing
- Health Care Costs
- Heredity
- Humans
- Life Expectancy
- Magnetic Resonance Imaging
- Mammography
- Mastectomy
- Middle Aged
- Models, Economic
- Patient Selection
- Phenotype
- Predictive Value of Tests
- Prognosis
- Quality-Adjusted Life Years
- Risk Assessment
- Risk Factors
- Watchful Waiting
Keywords
- BRCA
- breast cancer
- cost-effectiveness
- multigene panel testing