Improving metastatic colorectal cancer treatment using real-world data

Researchers at the University of Melbourne Centre for Cancer Research have identified evidence gaps and a lack of consistency in approaches adopted by health economic evaluations of metastatic colorectal cancer treatments.

Professor Maarten IJzerman's Cancer Health Services Research groupPictured: Dr Koen Degeling (back, second from right), Martin Vu (front, far right), Professor Maarten IJzerman (back, third from right) and team.

Published in PharmacoEconomics, Dr Koen Degeling, Martin Vu, Professor Maarten IJzerman and collaborators shared findings of a comprehensive methodological review of health economic evaluations of systemic therapies for metastatic colorectal cancer.

Results show that the 51 reviewed studies have taken varied approaches in terms of modelling methods and model structures, which has resulted in substantially different estimates of the health economic impact of systemic treatment options.

To date, health economic studies have primarily focused on first-line treatment options, mostly without considering downstream treatment effects and the impact of other treatments, such as the surgical removal of metastases, and without a standardised best standard-of-care treatment strategy.

Dr Degeling said that because of the lack of, or reporting on, model validation and analysis, and the wide variation in structural assumptions, the overall health economic impact of treatment options across a total course of metastatic colorectal cancer is highly uncertain.

“Moving forward, use of real-world data to analyse patterns of care in clinical practice across multiple lines of treatment and including non-drug treatment seems essential to reach appropriate model structures and comparators” he said, adding that “clinical registries can be a valuable, much needed source of evidence on the downstream effects of changes in upfront treatments”.

“Collaboration with clinical researchers was essential to put all modelling efforts into clinical context, and we were fortunate to work closely with international leaders from the Walter & Eliza Hall Institute and University Medical Centre Utrecht in the Netherlands on this study.”

Professor IJzerman’s Cancer Health Services Research group is based in the University of Melbourne Centre for Cancer Research and School of Population and Global Health, focused on improving cancer health services by analysing outcomes and costs of comprehensive cancer care.

Watch Dr Koen Degeling’s seminar on using clinical registries to improve outcomes for future patients, which discusses this paper.