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 For the study, researchers examined data from 193 late-stage trials
from the National Cancer Institute-funded SWOG research program,
originally called the Southwest Oncology Group. All of these studies
were done between 1962 and 2014 and were designed to prove that new
treatments were better than existing therapies; 23 of them succeeded
in this goal.
Without SWOG, “patients would have less access to new trials, there
would be slower development of new treatments, and the breadth and
diversity of trials would be much more limited,” said lead study
author Joseph Unger of the SWOG Statistical Center at the Fred
Hutchinson Cancer Research Center in Seattle.
“The cooperative groups conduct trials that are not strictly related
to new drug development, testing such things as the effectiveness of
different treatments that are already in clinical use, the
combination of different therapies developed by different sponsors,
therapies for rare diseases, and therapies that combine different
treatment modalities such as radiation therapy in combination with
chemotherapy,” Unger said by email.
Taxpayers have invested an estimated $418 million in SWOG treatment
trials since the program began, Unger and colleagues estimate in
JAMA Oncology.
This includes the cost of all trials, including tests of new
treatments that prove ineffective or unsafe as well as new therapies
that ultimately succeed in offering patients a better shot at
survival.
For the 23 successful trials, researchers calculated how many cancer
patients might survive for a year who might otherwise have died
without the new therapies developed through the SWOG effort.
By dividing those years of life saved by the estimated cost of all
SWOG studies since 1956, Unger and his colleagues calculated that it
took a National Cancer Institute investment of only $125 for each
year of life saved.
Most of the gained years of life have come since 1990, reflecting
the faster pace of new treatment discoveries in recent years.
With these more recent discoveries, the SWOG trials will have added
about 6.29 million years of life for all cancer patients in the U.S.
by 2030 at an estimated cost of $104 for each year of life gained.
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These calculations are based on the assumption that practice changes
were adopted by the oncology community upon publication of the SWOG
findings, researchers note. Delayed adoption of new therapies
developed in the trials might reduce the years of life saved.
The researchers basically took survival results from SWOG trials and
applied them to patients “with the same cancer at that time in the
U.S. population to determine how many years of life the introduction
of this new treatment into the general population with that same
stage of cancer would have gained, compared to the standard
treatment used before the trial results were available,” Dr. Jeffrey
Abrams of the National Cancer Institute said by email.
Some people have questioned whether these trials truly yield
meaningful benefits for patients, and funding for this research
program has progressively declined over the years, noted Dr. Ethan
Basch, an oncologist at the Lineberger Comprehensive Cancer Center
at University of North Carolina who wasn’t involved in the study.
“These days, only a limited number of these trials can be done,”
Basch said by email. “This new study shows that in fact, these
studies yield enormous benefits for patients.”
Unger and colleagues also presented their results at the annual
meeting of the American Society of Clinical Oncology in Chicago.
SOURCE: http://bit.ly/2sKsMr9 JAMA Oncology, online June 5, 2017.
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