Cancer drugs may be just as effective — and cheaper — at lower doses, oncologists say

Lower doses and shorter treatment periods may not reduce the efficacy of many cancer drugs, says a group of oncologists researching ways to lower cancer treatment costs.

The oncologists — who formed the nonprofit Value in Cancer Care consortium to guide their research efforts — completed a pilot study of 72 patients with prostate cancer, reports The Washington Post.

Half of the patients took the standard recommended 1,000-milligram dose of the cancer drug Zytiga on an empty stomach. The other half took a 250-milligram dose of the drug with a low-fat breakfast. The researchers found the lower dose drug regimen was just as effective as the full dose, and both patient groups went 14 months before the disease progressed, according to the report.

Janssen Pharmaceuticals — which manufactures Zytiga — warned against taking the drug at a lower dose with food, according to the report. "Given the variation in the content and composition of meals, the recommendation is to take Zytiga exactly as described in the prescribing information," the drugmaker said in a statement.

Lowering the dosage of Zytiga, which costs $9,400 per month, would greatly reduce costs for patients — even well-insured ones, according to Russell Szmulewitz, MD, a University of Chicago Medicine oncologist.

"This is the most practical and realistic way we have available right now to reduce the cost of cancer therapy and to increase value," Consortium Chairman Allen Lichter, MD, former president of the American Society of Clinical Oncology, told The Washington Post. "It doesn't require Congress to do anything or regulators to approve imports. It involves careful clinical study to show the oncology community some of these drugs can be used better. This is a win-win situation if we can show it works."

Dr. Szmulewitz and other physician researchers want to run larger trials to assess the efficacy of lower doses of other oncology drugs. They also seek to investigate whether treatment durations can be shortened by swapping out more expensive cancer medications for cheaper drugs not typically used to treat cancer, according to The Washington Post.

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