Do New Cancer Drugs Increase Overall Clinical Benefit?

A new study published in JAMA Oncology on Dec. 29, 2016 assessed overall survival, quality of life, and patient safety for 53 cancer drugs approved from 2003–2013. The researchers used a narrative synthesis approach to review analyses of new cancer drugs written by health technology assessment (HTA) agencies in England, Australia, and France. Researchers found that newer cancer drugs extend the life of patients an average of 3.43 months longer than do the drugs that were available in 2003.

The study determined that overall survival varied depending upon the drug and type of cancer. New breast cancer drugs extended overall patient survival 8.48 months on average, while new treatments for thyroid cancers saw no increase in survival compared with treatments available in 2003.

The researchers also examined patient quality of life and drug safety. Of the 53 drugs studied, 22 were determined to improve patient quality of life by a HTA agency (22%). Only two drugs reduced quality of life, and one displayed mixed results. The researchers found that 24 drugs (45%) reduced overall patient safety, which was determined by looking at adverse events and patient tolerance of the drug. Ten drugs demonstrated mixed results and 11 showed no difference from treatments available in 2003.

"Our results point to the notion that new cancer treatments may not always provide patients with greater clinical benefits, or lower risks, over existing treatments," said Elias Mossialos, MD, PhD, professor of Health Policy at the London School of Economics and Political Science, who is one of the study authors.

The global oncological drug market soared to approximately $107 billion in 2015, IMSQuintiles said in a report. New cancer treatments can carry hefty price tags for US patients who are estimated to have forked over $19.3 billion in 2015 for oncology, hepatitis, and autoimmune diseases, IMS said. In the JAMA study, the researchers noted that it may be important to further examine clinical benefit of oncological drugs compared with expenditures. While it is encouraging that new oncology drugs do show some increase in patient survival, they wrote, the findings raise questions about the “value-for-money in oncology.”

“Though further research is needed, our analysis may indicate that spending on new cancer drugs is not always commensurate with their clinical benefits,” the researchers wrote. “This may be reason for patients and clinicians to take pause when considering new treatments, particularly if related expenditures are of concern.”

Source: JAMA Oncology