Clinical trial participation for patients with cancer often result in measurable benefits, including lowered costs and extended survival.
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Over 50 years ago, the National Cancer Institute (NCI) established a network of publicly funded cancer cooperative research groups to evaluate novel treatments for safety and efficacy. However, the extent to which these NCI-sponsored cancer treatment trials have benefited patients with cancer in the United States population has yet to be measured.
Joseph M Unger, PhD, MS, SWOG Statistical Center (Seattle, WA) and colleagues investigated NCI-sponsored cancer treatment trials to measure cost and survival benefits for participants involved in the studies. A total of 23 SWOG—an NCI-sponsored network cooperative research group—treatment trials from multiple disease settings conducted between 1965 and 2012 were identified for which the therapy being tested was deemed positive – or providing a statistically significant improvement in overall survival. In total, 12,361 patients were enrolled in the trials. Results of the investigation were published in JAMA Oncology (published online June 5, 2017; doi:10.1001/jamaoncol.2017.0762).
Population life-years gained were estimated by mapping the effect of the novel treatments onto the US cancer population using a Kaplan-Meier survival curve. Calculations were age adjusted. The US dollar return on investment was estimated as the ratio of the total investment by the NCI in the treatment trial program divided by estimated life-years gained.
Results of the investigation estimate that 3.34 million (95% CI, 2.39-4.15 million) life-years were gained from the 23 trials. Estimates were greater than 2 million life-years gained under most model simulations.
Additionally, the US dollar return on investment estimate was $125 per life-year gained.
Researchers concluded that SWOG treatment trials have had a substantial impact on population survival for patients with cancer since their inception. “The NCI’s investment in its cancer cooperative group research program has provided exceptional value and benefit to the American public through its research programs generating positive cancer treatment trials,” they wrote.
Authors of the investigation acknowledged that their model for calculating life-years gained was limited, due to its simplified representation of the complicated manner in which new, trial-proven treatments translate to the cancer population.—Zachary Bessette
