Projected increases of cancer-attributable health-care costs, accompanied by staff shortages, will impose future economic and operational challenges on national health-care systems. Herein, we highlight a series of clinical and health economic rationales in support of publicly funded clinical trial teams that conduct real-world dose-reduction trials aiming for adjustment of cancer drug label doses to reduce not only the financial burden on payers, but also the toxicity burden on patients.
This is a preview of subscription content, access via your institution
Access options
Access Nature and 54 other Nature Portfolio journals
Get Nature+, our best-value online-access subscription
$29.99 / 30 days
cancel any time
Subscribe to this journal
Receive 12 print issues and online access
$209.00 per year
only $17.42 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
References
Shah, M., Rahman, A., Theoret, M. R. & Pazdur, R. The drug-dosing conundrum in oncology - when less is more. N. Engl. J. Med. 385, 1445–1447 (2021).
WHO-IARC. Estimated increase of cancer incidence world-wide 2020–2040. gco.iarc.fr, https://gco.iarc.fr/tomorrow/en/dataviz/bars?types=0&;sexes=0&mode=population&group_populations=1&multiple_populations=1&multiple_cancers=0&cancers=39&populations=903_904_905_908_909_935 (2023).
NIH. Prevalence of cancer patients in the US 2022–2040. cancer.control.cancer.gov, https://cancercontrol.cancer.gov/ocs/statistics (accessed 6 October 2023).
Darzi, A. & Evans, T. The global shortage of health workers-an opportunity to transform care. Lancet 388, 2576–2577 (2016).
Gourd, E. Concern over cancer treatment delays caused by staffing shortages. Lancet Oncol. 24, 721 (2023).
Vokinger, K. N. et al. Prices and clinical benefit of cancer drugs in the USA and Europe: a cost-benefit analysis. Lancet Oncol. 21, 664–670 (2020).
Mariotto, A. B., Enewold, L., Zhao, J., Zeruto, C. A. & Yabroff, K. R. Medical care costs associated with cancer survivorship in the United States. Cancer Epidemiol. Biomarkers Prev. 29, 1304–1312 (2020).
Kater, A. P. et al. Minimal residual disease-guided stop and start of venetoclax plus ibrutinib for patients with relapsed or refractory chronic lymphocytic leukaemia (HOVON141/VISION): primary analysis of an open-label, randomised, phase 2 trial. Lancet Oncol. 23, 818–828 (2022).
Drummond, M., Sculpher, M. J., Claxton, K., Stoddart, G. L. & Torrance, G. W. Methods for the Economic Evaluation of Health Care Programmes (Oxford Univ. Press, 2015).
Acknowledgements
The work of K.T.M. is supported by a Novo Nordisk Foundation clinical research fellowship (grant no. 100191) and centre grant (Novo Nordisk Foundation Center for Stem Cell Biology, DanStem, grant no. NNF17CC0027852), by the Danish Council for Strategic Research (grant no. 2034-00089B), the Danish Cancer Society (grant no. R302-A17376), Børnecancerfonden (2021-7385), the Danish Health Regions, and the Sven Andersen Fonden. The work of L.E. is supported by Nordic Institute of Health Economics A/S.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
The authors declare no competing interests.
Supplementary information
Rights and permissions
About this article
Cite this article
Theilgaard-Mönch, K., Ehlers, L.H. Dose-reduction trials in oncology — aiming for less toxicity and better quality of life at lower costs. Nat Rev Clin Oncol 21, 81–82 (2024). https://doi.org/10.1038/s41571-023-00831-5
Published:
Issue Date:
DOI: https://doi.org/10.1038/s41571-023-00831-5
