Over the past 40 years in the United States, people diagnosed with cancer have gained an additional 14 million years of life thanks to the results of cancer clinical trials conducted by the National Clinical Trials Network (NCTN) funded by the National Cancer Institute (NCI), according to an analysis due on September 20, 2021, at the annual meeting of the European Society for Medical Oncology (ESMO).
The work, which analyzed the results and impact of 163 randomized phase III studies published from 1980 to 2019, also found that the published results of these NCTN studies were cited more than 166,000 times, and that more than 80 % of studies influenced treatment. guideline recommendations, demonstrating the profound scientific impact of these trials on cancer research and care over decades.
The analysis was supported by the NCI, which is part of the National Institutes of Health (NIH), and was designed and led by the SWOG Cancer Research Network, which is part of the NCTN.
SWOG biostatistician and health services researcher Joseph Unger, PhD, of the Fred Hutchinson Cancer Research Center, led the analysis.
Our study illustrates the many ways in which federally sponsored trials have benefited the lives of cancer patients and the scientific field. There are many, many new, commonly used treatments available for patients that may never have been practiced without NCTN trials. “
Joseph Unger, PhD, Fred Hutchinson Cancer Research Center
The Chairman of the SWOG Group, Dr Charles Blanke, is the lead author of the summary. “We have always known that NCTN’s research has profoundly benefited the lives of those affected by cancer,” said Blanke. “The work of Dr Unger quantify which benefits and demonstrates that cooperative research is an incredibly low-cost, high-impact investment. “
The NCTN includes four groups that research cancer in adults (Alliance for Clinical Trials in Oncology, ECOG-ACRIN Cancer Research Group, NRG Oncology and SWOG Cancer Research Network) and a group that researches childhood cancers (Children’s Oncology Group ). These groups are at the heart of a network that conducts clinical trials at more than 2,000 academic and community treatment sites in the United States and beyond, and they conduct publicly-funded research into effective new treatments for cancer for over half a century.
The present study examined randomized phase III treatment trials conducted by adult NCTN groups. The authors identified 163 trials that, from 1980 to 2019, reported statistically significant results in favor of experimental treatment for at least one time-dependent clinical outcome. They then estimated the gains in years of life for the 128 trials that found either a statistically significant improvement in overall survival time (91 trials) or a trend towards improving overall survival (37 trials) for them. patients, and they mapped those gains on the US population of people. with cancer. The analysis reveals that until 2020, these test results gave an additional 14.0 million years of life to people with cancer in the United States.
“Dr. Unger’s findings are all the more important at this time of rising costs of clinical research,” said Peter J. O’Dwyer, MD, group co-chair of the ECOG-ACRIN Cancer Research Group and co-author of the work. . “The return to the American people of government-funded investments in better cancer care has been remarkably strong – a huge impact. “
And the benefits of these NCTN trials are expected to continue to accrue.
“When we project estimates into the future, the estimates increase very quickly,” noted Unger. In fact, the authors projected that by 2030, 23.4 million life years will have been gained based on the same set of tests.
“The results of these cancer clinical trials reflect the experience of participants from community and academic sites and show a dramatic gain in life years,” said Dr. Meg Mooney, Associate Director of the Therapy Evaluation Program. against cancer from NCI. “This work demonstrates the impact that large-scale national cancer clinical trials have on cancer research and on people with cancer.”
The results of most studies have been published either in the New England Journal of Medicine (49 trials) or the Journal of Clinical Oncology (72 trials). These published results were cited 166,711 times in subsequent publications, an average of 64 citations per year for each trial, influencing subsequent cancer research and guidelines for the treatment of cancer patients. In fact, over 80% of trials were cited in cancer treatment guidelines in favor of recommended treatments.
“When we think of re-energizing the infrastructure of the United States,” Unger added, “it’s important to remember that the NCTN provides critical infrastructure to help extend the lives of cancer patients.”
SWOG Cancer Research Network
Unger, JM, et al. (2021) Clinical and scientific impact of the National Cancer Institute: group treatment trials in a network of sponsored clinical trials. Annals of Oncology. doi.org/10.1016/annonc/annonc711.