There are a lot of ideas about ways to increase the value of cancer care, but personalized treatments may be the most significant and immediate.
Individualized medication doses, particularly for oral chemotherapy, is one area already being explored, but oncology thought leaders say there may be room for increased values in other treatment modalities, as well. Radiology, for example, has the potential to yield substantial savings by personalizing treatments, according to Daniel A. Goldstein, MD, of a medical oncologist at Rabin Medical Center in Israel and lecturer at Tel Aviv University.
"In the era of personalized treatment, one thing research could lead to is the ability to also give personalized treatment frequency," Goldstein says. "We may be able to check the level of drugs in a patient's blood stream and tell then when to get their next treatment."
Goldstein co-authored a study in early 2019 detailing the potential of hypofractionated radiation. The study focused on localized prostate cancer, for which intensified radiotherapy has been the standard radiation therapy. However, the report notes that several studies have now demonstrated similar results and patient outcomes with moderate hyfractionation. Researchers in this particular study analyzed the cost of external beam radiotherapy (EBRT) for localized prostate cancer, comparing the cost of intense versus moderate hypofractionation. The team found that the cost of standard fractionation was 45 or 39 fractions at a cost of $26,782 and $23,625 per patient, respectively, while the cost of moderate fractionation was 28 or 20 fractions at a cost of $17,793 and $13,402 per patient. The researcher team estimated that this change—which would not compromise survival or tolerability of treatments—could lower the cost of radiation treatments for localized prostate cancer alone by 25% to 50% annually, translating to somewhere between $150 million and $360 million in yearly savings.
Goldstein says he and his colleagues are currently trying to enlist payers who would like to participate in additional trials of programs that used personalized radiation therapy in other types of cancer, as well.