SCOT: a comparison of cost-effectiveness from a large randomised phase III trial of two durations of adjuvant Oxaliplatin combination chemotherapy for colorectal cancer. Issue 11 (27th November 2018)

• Record Type: Journal Article
• Authors: Robles-Zurita, José; Boyd, Kathleen; Briggs, Andrew; Iveson, Timothy; Kerr, Rachel; Saunders, Mark; Cassidy, Jim; Hollander, Niels; Tabernero, Josep; Segelov, Eva; Glimelius, Bengt; Harkin, Andrea; Allan, Karen; McQueen, John; Pearson, Sarah; Waterston, Ashita; Medley, Louise; Wilson, Charles; Ellis, Richard; Essapen, Sharadah; Dhadda, Amandeep; Hughes, Rob; Falk, Stephen; Raouf, Sherif; Rees, Charlotte; Olesen, Rene; Propper, David; Bridgewater, John; Azzabi, Ashraf; Farrugia, David; Webb, Andrew; Cunningham, David; Hickish, Tamas; Weaver, Andrew; Gollins, Simon; Wasan, Harpreet; Paul, James;
• Is Part Of: British journal of cancer. Volume 119:Issue 11(2018)
• Page Start: 1332
• Page End: 1338
• Publication Date: 2018-11-27
• Subjects: Cancer -- Periodicals; Cancer -- Research -- Periodicals; Tumors -- Periodicals; 616.994
• DOI: 10.1038/s41416-018-0319-z
• Languages: English
• ISSNs: 0007-0920

Abstract

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.