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

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

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.

0007-0920
1332-1338
Robles-Zurita, José
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Boyd, Kathleen A.
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Briggs, Andrew H.
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Iveson, Timothy
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Kerr, Rachel S.
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Saunders, Mark P.
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Cassidy, Jim
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Hollander, Niels Henrik
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Tabernero, Josep
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Segelov, Eva
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Harkin, Andrea
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McQueen, John
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Pearson, Sarah
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Wilson, Charles
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Gollins, Simon
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Iveson, Timothy
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Gollins, Simon
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Robles-Zurita, José, Boyd, Kathleen A., Briggs, Andrew H., Iveson, Timothy, Kerr, Rachel S., Saunders, Mark P., Cassidy, Jim, Hollander, Niels Henrik, 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 S., Hughes, Rob, Falk, Stephen, Raouf, Sherif, Rees, Charlotte, Olesen, Rene K., Propper, David, Bridgewater, John, Azzabi, Ashraf, Farrugia, David, Webb, Andrew, Cunningham, David, Hickish, Tamas, Weaver, Andrew, Gollins, Simon, Wasan, Harpreet S. and Paul, James (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. (doi:10.1038/s41416-018-0319-z).

Record type: Article

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.

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More information

Accepted/In Press date: 9 October 2018
e-pub ahead of print date: 13 November 2018
Published date: 27 November 2018

Identifiers

Local EPrints ID: 444685
URI: http://eprints.soton.ac.uk/id/eprint/444685
ISSN: 0007-0920
PURE UUID: 9b05f8cd-56f3-4110-970d-47651d94f61a
ORCID for Timothy Iveson: ORCID iD orcid.org/0000-0002-4681-2712

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Date deposited: 29 Oct 2020 17:33
Last modified: 18 Mar 2024 02:47

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Contributors

Author: José Robles-Zurita
Author: Kathleen A. Boyd
Author: Andrew H. Briggs
Author: Timothy Iveson ORCID iD
Author: Rachel S. Kerr
Author: Mark P. Saunders
Author: Jim Cassidy
Author: Niels Henrik Hollander
Author: Josep Tabernero
Author: Eva Segelov
Author: Bengt Glimelius
Author: Andrea Harkin
Author: Karen Allan
Author: John McQueen
Author: Sarah Pearson
Author: Ashita Waterston
Author: Louise Medley
Author: Charles Wilson
Author: Richard Ellis
Author: Sharadah Essapen
Author: Amandeep S. Dhadda
Author: Rob Hughes
Author: Stephen Falk
Author: Sherif Raouf
Author: Charlotte Rees
Author: Rene K. Olesen
Author: David Propper
Author: John Bridgewater
Author: Ashraf Azzabi
Author: David Farrugia
Author: Andrew Webb
Author: David Cunningham
Author: Tamas Hickish
Author: Andrew Weaver
Author: Simon Gollins
Author: Harpreet S. Wasan
Author: James Paul

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