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Proffered Paper session - Public policy

1503O - Clinical and scientific impact of National Cancer Institute: Sponsored clinical trial network group treatment trials

Date

20 Sep 2021

Session

Proffered Paper session - Public policy

Presenters

Joseph Unger

Citation

Annals of Oncology (2021) 32 (suppl_5): S1102-S1110. 10.1016/annonc/annonc711

Authors

J.M. Unger1, M. LeBlanc1, M. Bertagnolli2, N. Wolmark3, W.J. Curran4, P.J. O'Dwyer5, M.D. Schnall6, R.S. Mannel7, J.P. Costantino8, R.J. Gray9, F. Zhao10, F. Hong11, M. Bah12, R. Vaidya12, C.D. Blanke13

Author affiliations

  • 1 Public Health Sciences Division, Fred Hutchinson Cancer Research Center, 98109-1024 - Seattle/US
  • 2 Surgical Oncology, Brigham and Women's Hospital, 2115 - Boston/US
  • 3 Allegheny Cancer Center, Allegheny General Hospital, PA 15212 - Pittsburgh/US
  • 4 Medicine Department, Winship Cancer Institute of Emory University, 30322 - Atlanta/US
  • 5 Medical Oncology, University of Pennsylvania - Franklin Building, 19104 - Philadelphia/US
  • 6 Medical Oncology, Verwoerd Hospital, 0002 - Pretoria/ZA
  • 7 Medical Oncology, Stephenson Cancer Center, 73104 - Oklahoma City/US
  • 8 Biostatistics, The University of Pittsburgh, 15213 - Pittsburgh/US
  • 9 Biostatistics, Dana Farber Cancer Institute, 2115 - Boston/US
  • 10 Biostatistics, Dana Farber Cancer Institute, 2148 - Boston/US
  • 11 Biostatistics, Harvard University, 02467 - Boston/US
  • 12 Public Health Sciences Division, Fred Hutchinson Cancer Research Center, 98109 - Seattle/US
  • 13 Medicine Department, SWOG Cancer Research Network, 97201 - Portland/US
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Resources

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Abstract 1503O

Background

In the U.S., the NCI National Cancer Clinical Trials Network (NCTN) groups have conducted publicly funded cancer research for more than 50 years. A major aim of the groups is to identify effective new treatments for patients with cancer. The impact of all adult network group trials has never been systematically examined.

Methods

We identified randomized, phase III trials from the adult NCTN groups (SWOG, Alliance, NRG, and ECOG-ACRIN), reported from 1980 onward, with statistically significant findings for at least one clinical, time-dependent outcome. Gains in population life-years attributable to the network-group trials were calculated by: 1) deriving trial-specific hazard functions and hazard ratios to estimate area under the Kaplan-Meier survival curve between standard and experimental treatments, and, 2) mapping the trial-level benefit of experimental treatment onto the U.S. cancer population using national cancer registry and life table data. Life-years were estimated from trials for which overall survival favored the experimental treatment arm. Scientific impact was assessed according to citation data from Google Scholar. Results were estimated through January 1, 2020.

Results

In total, 163 trials comprised of N=108,102 patients were analyzed, representing 30.9% (163/528) of estimated trials conducted. The most common cancers included breast (33), gynecologic (28), lung (15), and prostate (12). The trials were cited 166,771 times (mean, 64 citations/year/trial). Overall, 128 trials showed overall survival favoring the experimental arm; these trials were estimated to have generated gains of 14.0 million life-years to cancer patients. Evaluations of the rate at which these trials influenced clinical care guidelines and the cost per life-year gained are ongoing and will also be analyzed and presented.

Conclusions

NCTN randomized trials have generated substantial gains in life years for patients with cancer and have enormous influence on the cancer field, as reflected by the extent to which they are cited in other research studies. Collectively the efforts of the NCI network groups have demonstrated the critical role of government-sponsored cancer research in extending the lives of patients with cancer.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

SWOG Cancer Research Network.

Funding

National Cancer Institute, National Institutes of Health.

Disclosure

M. LeBlanc: Financial Interests, Personal, Advisory Role: Agios. M. Bertagnolli: Financial Interests, Institutional, Research Grant: Abbvie; Financial Interests, Institutional, Research Grant: Agenus; Financial Interests, Institutional, Research Grant: Astellas Pharma; Financial Interests, Institutional, Research Grant: AstraZeneca; Financial Interests, Institutional, Research Grant: Breast Cancer Research Foundation; Financial Interests, Institutional, Research Grant: Bristol-Myers Squibb; Financial Interests, Institutional, Research Grant: Celgene; Financial Interests, Institutional, Research Grant: Complion; Financial Interests, Institutional, Research Grant: Exelixis; Financial Interests, Institutional, Research Grant: Genentech; Financial Interests, Institutional, Research Grant: GHI Pharma; Financial Interests, Institutional, Research Grant: Gilead Sciences; Financial Interests, Institutional, Research Grant: GlaxoSmithKline; Financial Interests, Institutional, Research Grant: Incyte; Financial Interests, Institutional, Research Grant: Jazz Pharmaceuticals; Financial Interests, Institutional, Research Grant: Leidos; Financial Interests, Institutional, Research Grant: Lilly; Financial Interests, Institutional, Research Grant: Matrex; Financial Interests, Institutional, Research Grant: Mayo Clinic; Financial Interests, Institutional, Research Grant: Massachusetts General Hospital; Financial Interests, Institutional, Research Grant: Millenium Pharmaceuticals; Financial Interests, Institutional, Research Grant: Novartis; Financial Interests, Institutional, Research Grant: Patient-Centered Outcomes Research Institute; Financial Interests, Institutional, Research Grant: Pfizer; Financial Interests, Institutional, Research Grant: Robert Wood Johnson Foundation; Financial Interests, Institutional, Research Grant: Sagerock Advisors; Financial Interests, Institutional, Research Grant: Taiho Pharmaceutical; Financial Interests, Institutional, Research Grant: Bayer Health; Financial Interests, Institutional, Research Grant: Eisai; Financial Interests, Institutional, Research Grant: Lexicon; Financial Interests, Institutional, Research Grant: Merck; Financial Interests, Institutional, Research Grant: Pharmacyclics; Financial Interests, Institutional, Research Grant: Takeda; Financial Interests, Institutional, Research Grant: Tesaro; Financial Interests, Institutional, Research Grant: Baxalta; Financial Interests, Institutional, Research Grant: Sanofi; Financial Interests, Institutional, Research Grant: Teva; Financial Interests, Institutional, Research Grant: Janssen; Financial Interests, Institutional, Research Grant: MITRE Corporation; Financial Interests, Institutional, Research Grant: Chinese Medical Education Association; Financial Interests, Institutional, Research Grant: Servier; Non-Financial Interests, Personal, Other, Uncompensated Relationship: Leap Therapeutics; Non-Financial Interests, Personal, Other, Uncompensated Relationship: Natera. P.J. O'Dwyer: Financial Interests, Personal, Advisory Role: Genentech; Financial Interests, Personal, Advisory Role: Array BioPharma; Financial Interests, Personal, Expert Testimony: Lilly; Financial Interests, Institutional, Research Grant: Bristol-Myers Squibb; Financial Interests, Institutional, Research Grant: Pfizer; Financial Interests, Institutional, Research Grant: Novartis; Financial Interests, Institutional, Research Grant: Genentech; Financial Interests, Institutional, Research Grant: Mirati Therapeutics; Financial Interests, Institutional, Research Grant: Celgene; Financial Interests, Institutional, Research Grant: GlaxoSmithKline; Financial Interests, Institutional, Research Grant: BBI Healthcare; Financial Interests, Institutional, Research Grant: Pharmacyclics; Financial Interests, Institutional, Research Grant: Five Prime Therapeutics; Financial Interests, Institutional, Research Grant: Forty Seven; Financial Interests, Institutional, Research Grant: Amgen; Financial Interests, Institutional, Research Grant: H3 Biomedicine; Financial Interests, Institutional, Research Grant: Taiho Pharmaceutical; Financial Interests, Institutional, Research Grant: Array BioPharma; Financial Interests, Institutional, Research Grant: Lilly/ImClone; Financial Interests, Institutional, Research Grant: Syndax; Financial Interests, Institutional, Research Grant: Minneamrita Therapeutics. M.D. Schnall: Financial Interests, Personal and Institutional, Other, Travel, Accommodations, Expenses: Sectra; Financial Interests, Personal and Institutional, Research Grant: Siemens Healthineers. R.S. Mannel: Financial Interests, Institutional, Advisory Role: Tesara. R.J. Gray: Financial Interests, Personal, Research Grant: Agios; Financial Interests, Personal, Research Grant: Amgen; Financial Interests, Personal, Research Grant: AstraZeneca; Financial Interests, Personal, Research Grant: Bristol-Myers Squibb; Financial Interests, Personal, Research Grant: Boehringer Ingelheim; Financial Interests, Personal, Research Grant: Celgene; Financial Interests, Personal, Research Grant: Genentech/Roche; Financial Interests, Personal, Research Grant: Genomic Health; Financial Interests, Personal, Research Grant: Genzyme; Financial Interests, Personal, Research Grant: GlaxoSmithKline; Financial Interests, Personal, Research Grant: Janssen-Ortho; Financial Interests, Personal, Research Grant: Onyx; Financial Interests, Personal, Research Grant: Pfizer; Financial Interests, Personal, Research Grant: Sequenta; Financial Interests, Personal, Research Grant: Syndax; Financial Interests, Personal, Research Grant: Novartis; Financial Interests, Personal, Research Grant: Takeda; Financial Interests, Personal, Research Grant: Abbvie; Financial Interests, Personal, Research Grant: Sanofi; Financial Interests, Personal, Research Grant: Merck Sharp & Dohme. F. Hong: Financial Interests, Personal, Advisory Role: Merck Sharp and Dohme. All other authors have declared no conflicts of interest.

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