SCOT: a comparison of cost-effectiveness from a large randomised phase III trial of two durations of adjuvant Oxaliplatin combination chemotherapy for colorectal cancer.

Robles-Zurita, J., Boyd, K.A., Briggs, A.H., Iveson, T., Kerr, R.S., Saunders, M.P., Cassidy, J., Hollander, N.H., Tabernero, J., Segelov, E., Glimelius, B., Harkin, A., Allan, K., McQueen, J., Pearson, S., Waterston, A., Medley, L., Wilson, C., Ellis, R., Essapen, S., Dhadda, A.S., Hughes, R., Falk, S., Raouf, S., Rees, C., Olesen, R.K., Propper, D., Bridgewater, J., Azzabi, A., Farrugia, D., Webb, A., Cunningham, D., Hickish, T. F., Weaver, A., Gollins, S., Wasan, H.S. and Paul, J., 2018. SCOT: a comparison of cost-effectiveness from a large randomised phase III trial of two durations of adjuvant Oxaliplatin combination chemotherapy for colorectal cancer. British Journal of Cancer, 119 (11), 1332 - 1338.

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DOI: 10.1038/s41416-018-0319-z

Abstract

BACKGROUND: The Short Course Oncology Therapy (SCOT) study is an international, multicentre, non-inferiority randomised controlled trial assessing the efficacy, toxicity, and cost-effectiveness of 3 months (3 M) versus the usually given 6 months (6 M) of adjuvant chemotherapy in colorectal cancer. METHODS: In total, 6088 patients with fully resected high-risk stage II or stage III colorectal cancer were randomised and followed up for 3-8 years. The within-trial cost-effectiveness analysis from a UK health-care perspective is presented using the resource use data, quality of life (EQ-5D-3L), time on treatment (ToT), disease-free survival after treatment (DFS) and overall survival (OS) data. Quality-adjusted partitioned survival analysis and Kaplan-Meier Sample Average Estimator estimated QALYs and costs. Probabilistic sensitivity and subgroup analysis was undertaken. RESULTS: The 3 M arm is less costly (-£4881; 95% CI: -£6269; -£3492) and entails (non-significant) QALY gains (0.08; 95% CI: -0.086; 0.230) due to a better significant quality of life. The net monetary benefit was significantly higher in 3 M under a wide range of monetary values of a QALY. The subgroup analysis found similar results for patients in the CAPOX regimen. However, for the FOLFOX regimen, 3 M had lower QALYs than 6 M (not statistically significant). CONCLUSIONS: Overall, 3 M dominates 6 M with no significant detrimental impact on QALYs. The results provide the economic case that a 3 M treatment strategy should be considered a new standard of care.

Item Type:Article
ISSN:0007-0920
Additional Information:Supplementary information is available for this paper at https://doi.org/10.1038/ s41416-018-0319-z. This work was supported by Medical Research Council (transferred to NETSCC— Efficacy and Mechanism Evaluation) (Grant Ref: G0601705) and Cancer Research UK Core CTU Funding (Funding Ref: C6716/A9894). The Study Sponsor was NHS Greater Glasgow & Clyde and University of Glasgow. Eudract Ref: 2007–003957-10; ISRCTN No.: 23516549.
Group:Faculty of Health & Social Sciences
ID Code:31549
Deposited By: Unnamed user with email symplectic@symplectic
Deposited On:12 Dec 2018 11:53
Last Modified:12 Dec 2018 11:53

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