What do cancer drugs improve?

Do cancer drugs improve survival or quality-of-life? A study published in @bmj_company shows that most new cancer drugs are failing to deliver any clinically meaningful benefit.

Using the EMA database of European Public Assessment Reports, the study identified 48 cancer drugs for 68 indications approved between 2009 and 2013 in Europe. To determine the availability of evidence on overall survival and quality of life gains, researchers manually searched the EMA website to identify the relevant European Public Assessment Reports (EPARs). Results were cross checked against the European Clinical Trials Database (EudraCT) and the U.S. National Library of Medicine database of clinical trials (ClinicalTrials.gov).

The European Society for Medical Oncology’s (ESMO) Magnitude of Clinical Benefit Scale (ESMO-MCBS) was used to assess clinical value.

There was an improvement in quality-of-life in only seven of 68 indications (10%). Forty-four (65%) indications had no evidence of a survival gain at the time of market authorization.

Out of the 68 cancer drug indications approved by the European Medicines Agency during 2009-13, 39 (57%) entered the market without evidence of a survival or quality-of -ife benefit. 

Add to this that the average cancer drug costs in excess of $100,000 (> £75,000; > €85,000) per year of treatment and facts start to paint a sobering picture.