Comparative and combined effectiveness of innovative therapies in cancer: a literature review

J Comp Eff Res. 2019 Mar;8(4):205-216. doi: 10.2217/cer-2018-0131. Epub 2019 Jan 8.

Abstract

To achieve therapeutic innovation in oncology, already expensive novel medicines are often concomitantly combined to potentially enhance effectiveness. While this aggravates the pricing problem, comparing effectiveness of novel yet expensive (concomitant) treatments is much needed for healthcare decision-making to deliver effective but affordable treatments. This study reviewed published clinical trials and real-world studies of targeted and immune therapies. In total, 48 studies compared and/or combined multiple novel products on breast, colorectal, lung and melanoma cancers. To a great extent, products evaluated in each study were owned by one manufacturer. However, cross-manufacturer assessments are also needed. Next to costs and intensive market competition, the absence of a regulatory framework enforcing real-world multiproduct studies prevents these from being conducted. Trusted third parties could facilitate such real-world studies, for which appropriate and efficient data access is needed.

Keywords: clinical studies; combination studies; comparative studies; immune-oncology; literature review; precision-oncology; real-world evidence.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Systematic Review

MeSH terms

  • Antineoplastic Agents, Immunological / therapeutic use
  • Breast Neoplasms / economics
  • Breast Neoplasms / therapy*
  • Colorectal Neoplasms / economics
  • Colorectal Neoplasms / therapy*
  • Combined Modality Therapy / economics
  • Combined Modality Therapy / methods
  • Female
  • Humans
  • Lung Neoplasms / economics
  • Lung Neoplasms / therapy*
  • Male
  • Medical Oncology
  • Melanoma / economics
  • Melanoma / therapy*
  • Treatment Outcome

Substances

  • Antineoplastic Agents, Immunological