Big returns on small cancer research investment, study suggests

(Reuters Health) - A government-backed research collaboration program started in the 1950s has added about 3.34 million years of life for cancer patients in the U.S. at an estimated cost of just $125 for each year of life gained based on successful new treatment options developed through the program, a new study estimates.

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.

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: JAMA Oncology, online June 5, 2017.