Nav: Home

New drugs, higher costs offer little survival benefit in advanced lung cancer

January 04, 2017

According to a University of Colorado Cancer Center study published this week in the Journal of Clinical Oncology, a decade that saw the development of new therapies for non-small cell lung cancer resulted in little survival benefit for patients with advanced-stage disease. In 22,163 patients treated between 2000 and 2011 with newly approved therapies including pemetrexed, erlotinib, or bevacizumab, survival increased by a median 1.5 months. Because these drugs were used in place of older chemotherapies and there was a declining trend in surgeries, inpatient spending fell about $5,600 per person, but this was more than offset by the cost of these new medicines, which raised outpatient spending by about $8,800 per person.

"As new therapies were introduced, they were rapidly adopted and the old therapies were abandoned. Across the population in the past 12 years, these newly approved therapies have made little difference in overall survival," says Cathy Bradley, PhD, associate director for population sciences research at CU Cancer Center.

Unlike clinical trial results, the current study looks beyond the optimal application of these drugs to their use in the real world. For example, Bradley points out, many of these targeted therapies are only useful when directed at a cancer with a specific biomarker but may be used irrespective of biomarker status.

"Take erlotinib," says Bradley. "A patient's tumor must by marked by EGFR for it to be beneficial. But when some patients reach the end of their established options, some oncologists may prescribe erlotinib without the EGFR biomarker in hopes that the patient will benefit."

The decision can be costly. Patients with cancer are 2.5 times more likely to declare bankruptcy than patients who have not had cancer. Bradley points out that in an era of rising drug costs and a higher financial burden placed on patients, treatment often costs $30-40K in out-of-pocket expenses.

"When you talk with patients, leaving their family in financial distress is an important concern," Bradley says.

As Bradley sees it, the challenge of these new medicines is to optimize their value by using them in the population most likely to benefit while working with patients to better understand the costs associated with treatment that may have little or no impact on survival.

"What we see here doesn't definitively mean these drugs are unsuccessful. It means that despite their promise in clinical trials, they haven't made a survival difference in the population. That may be because oncologists are giving them to people who will not benefit. Better predicting who will benefit from newer more expensive therapies is essential to making value-based decisions in the context of very high costs and new medicines," Bradley says.
-end-


University of Colorado Anschutz Medical Campus

Related Cancer Articles:

Stress in cervical cancer patients associated with higher risk of cancer-specific mortality
Psychological stress was associated with a higher risk of cancer-specific mortality in women diagnosed with cervical cancer.
Cancer-sniffing dogs 97% accurate in identifying lung cancer, according to study in JAOA
The next step will be to further fractionate the samples based on chemical and physical properties, presenting them back to the dogs until the specific biomarkers for each cancer are identified.
Moffitt Cancer Center researchers identify one way T cell function may fail in cancer
Moffitt Cancer Center researchers have discovered a mechanism by which one type of immune cell, CD8+ T cells, can become dysfunctional, impeding its ability to seek and kill cancer cells.
More cancer survivors, fewer cancer specialists point to challenge in meeting care needs
An aging population, a growing number of cancer survivors, and a projected shortage of cancer care providers will result in a challenge in delivering the care for cancer survivors in the United States if systemic changes are not made.
New cancer vaccine platform a potential tool for efficacious targeted cancer therapy
Researchers at the University of Helsinki have discovered a solution in the form of a cancer vaccine platform for improving the efficacy of oncolytic viruses used in cancer treatment.
American Cancer Society outlines blueprint for cancer control in the 21st century
The American Cancer Society is outlining its vision for cancer control in the decades ahead in a series of articles that forms the basis of a national cancer control plan.
Oncotarget: Cancer pioneer employs physics to approach cancer in last research article
In the cover article of Tuesday's issue of Oncotarget, James Frost, MD, PhD, Kenneth Pienta, MD, and the late Donald Coffey, Ph.D., use a theory of physical and biophysical symmetry to derive a new conceptualization of cancer.
Health indicators for newborns of breast cancer survivors may vary by cancer type
In a study published in the International Journal of Cancer, researchers from the UNC Lineberger Comprehensive Cancer Center analyzed health indicators for children born to young breast cancer survivors in North Carolina.
Few women with history of breast cancer and ovarian cancer take a recommended genetic test
More than 80 percent of women living with a history of breast or ovarian cancer at high-risk of having a gene mutation have never taken the test that can detect it.
Radiotherapy for invasive breast cancer increases the risk of second primary lung cancer
East Asian female breast cancer patients receiving radiotherapy have a higher risk of developing second primary lung cancer.
More Cancer News and Cancer Current Events

Top Science Podcasts

We have hand picked the top science podcasts of 2019.
Now Playing: TED Radio Hour

In & Out Of Love
We think of love as a mysterious, unknowable force. Something that happens to us. But what if we could control it? This hour, TED speakers on whether we can decide to fall in — and out of — love. Guests include writer Mandy Len Catron, biological anthropologist Helen Fisher, musician Dessa, One Love CEO Katie Hood, and psychologist Guy Winch.
Now Playing: Science for the People

#542 Climate Doomsday
Have you heard? Climate change. We did it. And it's bad. It's going to be worse. We are already suffering the effects of it in many ways. How should we TALK about the dangers we are facing, though? Should we get people good and scared? Or give them hope? Or both? Host Bethany Brookshire talks with David Wallace-Wells and Sheril Kirschenbaum to find out. This episode is hosted by Bethany Brookshire, science writer from Science News. Related links: Why Climate Disasters Might Not Boost Public Engagement on Climate Change on The New York Times by Andrew Revkin The other kind...
Now Playing: Radiolab

An Announcement from Radiolab