According to new research, the incremental clinical benefits and incremental drug costs of adding induction chemotherapy to concurrent chemoradiotherapy, concurrent chemotherapy to radiotherapy, and concurrent chemotherapy plus adjuvant chemotherapy to radiotherapy for locally advanced nasopharyngeal cancer, showed no significant differences. (JCO Oncol Pract. 2020;OP2000413. doi:10.1200/OP.20.00413)
In order to determine the incremental clinical benefits and incremental drug costs of these various treatment combinations for patients with locally advanced nasopharyngeal cancer, researchers searched Phase III randomized controlled trials. The trials included looked at the overall survival benefits with the use of induction chemotherapy, concurrent chemotherapy, and concurrent chemotherapy plus adjuvant chemotherapy.
The researchers used the ASCO and ESMO value frameworks to determine the incremental clinical benefits. Further, they used the lowest average wholesale price reported to calculate and determine incremental drug costs in US dollars.
The study authors identified three trials on induction chemotherapy, three trials on concurrent chemotherapy, and four trials on concurrent chemotherapy plus adjuvant chemotherapy. The researchers said that the incremental clinical benefit was judged to be grade A based on the ESMO framework, and the ASCO Net Health Benefit score ranged from 17.43 to 57.39.
According to the findings, the drug costs ranged from $133.46 to $626.14.
Further findings showed no statistically significant differences in the mean Net Health Benefit scores (39.37 for induction chemo versus 37.61 for concurrent chemo versus 33.98 for concurrent chemo + adjuvant chemo; P = .89), and for costs ($383 for induction chemo versus $253 for concurrent chemo versus $460 for concurrent chemo + adjuvant chemo; P = .27).
“There was no statistically significant correlation between [incremental clinical benefit] and costs,” they concluded.—Julie Gould
