While cancer drugs approved between 2003 and 2013 often improved quality of life, the average overall survival increase was only 3.43 months, and many drugs reduced patient safety, according to an article published in JAMA Oncology.1
It is often unclear whether a particular cancer treatment is worth the costs associated with its development and distribution. Overall survival is the standard measure by which a drug’s efficacy is determined, and drug approvals by the U.S. Food and Drug Administration (FDA) almost always depend on overall survival data.
Researchers evaluated overall survival assessments for 53 of the 62 molecules approved for treatment between 2003 and 2013. Fewer than half of the evaluated treatments improved overall survival by more than 3 months; the 10 immunologic drugs evaluated were, however, associated with an overall survival improvement of about 5 months. Ipilimumab in particular showed an overall survival improvement of 5.7 months.
Twenty-two of the evaluated drugs improved quality of life, according to the authors, while 28 did not improve or reduce quality of life. Only 8 drugs improved safety, while 24 reduced patient safety.
The authors noted, strikingly, that “these findings suggest that expenditures for up to 1 out of every 5 new cancer drugs may be spent without any OS [overall survival], QoL [quality of life], or safety benefit to the patient.”
Patients and clinicians ought, according to this study’s authors, to consider the evidence in favor of new therapies carefully before coming to a treatment decision. The relationship between value and cost for each approved drug should, furthermore, be a matter of close consideration in the future.
- Salas-Vega S, Iliopoulos O, Mossialos E. Assessment of overall survival, quality of life, and safety benefits associated with new cancer medicines. JAMA Oncol. 2016 Dec 29. doi:10.1001/jamaoncol.2016.4166 [Epub ahead of print]