TY - JOUR
T1 - Population, Clinical, and Scientific Impact of National Cancer Institute's National Clinical Trials Network Treatment Studies
AU - Unger, Joseph M.
AU - Leblanc, Michael
AU - George, Suzanne
AU - Wolmark, Norman
AU - Curran, Walter J.
AU - O'Dwyer, Peter J.
AU - Schnall, Mitchell D.
AU - Mannel, Robert S.
AU - Mandrekar, Sumithra J.
AU - Gray, Robert J.
AU - Zhao, Fengmin
AU - Bah, Mariama
AU - Vaidya, Riha
AU - Blanke, Charles D.
N1 - Funding Information:
The authors wish to thank the hundreds of thousands of patients putting their trust in the NCTN over the last 50+ years, and the NCI, for funding cancer studies in durable fashion for over 5 decades.
Publisher Copyright:
© American Society of Clinical Oncology.
PY - 2023/4/10
Y1 - 2023/4/10
N2 - PURPOSE In the United States, the National Cancer Institute National Cancer Clinical Trials Network (NCTN) groups have conducted publicly funded oncology research for 50 years. The combined impact of all adult network group trials has never been systematically examined.METHODSWe identified randomized, phase III trials from the adult NCTN groups, reported from 1980 onward, with statistically significant findings for ≥ 1 clinical, time-dependent outcomes. In the subset of trials in which the experimental arm improved overall survival, gains in population life-years were estimated by deriving trial-specific hazard functions and hazard ratios to estimate the experimental treatment benefit and then mapping this trial-level benefit onto the US cancer population using registry and life-table data. Scientific impact was based on citation data from Google Scholar. Federal investment costs per life-year gained were estimated. The results were derived through December 31, 2020.RESULTSOne hundred sixty-two trials comprised of 108,334 patients were analyzed, representing 29.8% (162/544) of trials conducted. The most common cancers included breast (34), gynecologic (28), and lung (14). The trials were cited 165,336 times (mean, 62.2 citations/trial/year); 87.7% of trials were cited in cancer care guidelines in favor of the recommended treatment. These studies were estimated to have generated 14.2 million (95% CI, 11.5 to 16.5 million) additional life-years to patients with cancer, with projected gains of 24.1 million (95% CI, 19.7 to 28.2 million) life-years by 2030. The federal investment cost per life-year gained through 2020 was $326 in US dollars.CONCLUSIONNCTN randomized trials have been widely cited and are routinely included in clinical guidelines. Moreover, their conduct has predicted substantial improvements in overall survival in the United States for patients with oncologic disease, suggesting they have contributed meaningfully to this nation's health. These findings demonstrate the critical role of government-sponsored research in extending the lives of patients with cancer.
AB - PURPOSE In the United States, the National Cancer Institute National Cancer Clinical Trials Network (NCTN) groups have conducted publicly funded oncology research for 50 years. The combined impact of all adult network group trials has never been systematically examined.METHODSWe identified randomized, phase III trials from the adult NCTN groups, reported from 1980 onward, with statistically significant findings for ≥ 1 clinical, time-dependent outcomes. In the subset of trials in which the experimental arm improved overall survival, gains in population life-years were estimated by deriving trial-specific hazard functions and hazard ratios to estimate the experimental treatment benefit and then mapping this trial-level benefit onto the US cancer population using registry and life-table data. Scientific impact was based on citation data from Google Scholar. Federal investment costs per life-year gained were estimated. The results were derived through December 31, 2020.RESULTSOne hundred sixty-two trials comprised of 108,334 patients were analyzed, representing 29.8% (162/544) of trials conducted. The most common cancers included breast (34), gynecologic (28), and lung (14). The trials were cited 165,336 times (mean, 62.2 citations/trial/year); 87.7% of trials were cited in cancer care guidelines in favor of the recommended treatment. These studies were estimated to have generated 14.2 million (95% CI, 11.5 to 16.5 million) additional life-years to patients with cancer, with projected gains of 24.1 million (95% CI, 19.7 to 28.2 million) life-years by 2030. The federal investment cost per life-year gained through 2020 was $326 in US dollars.CONCLUSIONNCTN randomized trials have been widely cited and are routinely included in clinical guidelines. Moreover, their conduct has predicted substantial improvements in overall survival in the United States for patients with oncologic disease, suggesting they have contributed meaningfully to this nation's health. These findings demonstrate the critical role of government-sponsored research in extending the lives of patients with cancer.
UR - http://www.scopus.com/inward/record.url?scp=85152168092&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85152168092&partnerID=8YFLogxK
U2 - 10.1200/JCO.22.01826
DO - 10.1200/JCO.22.01826
M3 - Article
C2 - 36480773
AN - SCOPUS:85152168092
SN - 0732-183X
VL - 41
SP - 2020
EP - 2028
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
IS - 11
ER -