Summary

Advice

The technology described in this briefing is Caris Molecular Intelligence (CMI). It is used to help guide future management of locally advanced or metastatic cancer.
The innovative aspects are that it uses multi-platform molecular profiling to provide a report describing which cancer treatments may have clinical benefit and any relevant, open clinical trials. The profile is based on the molecular characteristics of the patient's tumour, irrespective of its primary site.
The intended place in therapy would be as a tool to help guide treatment decisions for locally advanced or metastatic cancer in people who are fit for further treatment but have exhausted standard (evidence-based) treatment options and for whom no further guidance on therapy exists.
The main points from the evidence summarised in this briefing are from 5 observational studies in Australia and the US including a total of 1,572 adults in secondary and tertiary care centres. Most evidence shows that CMI‑guided treatment is associated with better progression-free survival than clinician decisions alone. There is also some evidence that CMI may lead to improved overall survival.
Key uncertainties around the evidence are that there are currently no randomised controlled studies comparing CMI‑guided treatment with non-CMI‑guided treatment. There is also limited evidence on CMI‑guided treatment for site-specific cancers and metastatic cancer of unknown primary origin, and no evidence on its use in children.
The cost of CMI is £5,800 per test (excluding VAT), which includes the cost of shipping the sample, the full report, and a consultation between the ordering clinician and a member of the company's medical team. The resource impact would be additional costs compared with standard care, including test costs, sample preparation and additional multidisciplinary team meetings. There is no published evidence assessing the cost effectiveness of CMI.