Original research
The European Society for Medical Oncology 'Magnitude of Clinical Benefit Scale' field-tested in infrequent tumour entities: an extended analysis of its feasibility at the Medical University of Vienna

https://doi.org/10.1136/esmoopen-2017-000166Get rights and content
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ABSTRACT

Background

The European Society for Medical Oncology Magnitude of Clinical Benefit Scale (ESMO-MCBS) is a new tool to quantify the clinical benefit that may be anticipated from a novel anticancer treatment. We present here an analysis on the feasibility of the ESMO-MCBS in less frequent tumour entities.

Methods

This study evaluates the practicability of the ESMO-MCBS for metastatic neuroendocrine tumours (NETs), soft tissue sarcomas, glioblastoma, thyroid cancer, pancreatic cancer, head/neck cancer, urothelial cancer and ovarian cancer at the Medical University Vienna. A three-step approach including data acquisition, assessment of ESMO-MCBS scores and evaluation of results with a focus on clinical feasibility was applied.

Results

In NET and thyroid cancer, all analysed trials were very comparable in design and efficacy, and the ESMO-MCBS scores appeared to be consistent with the clinical benefit seen in practice. For pancreatic cancer, it was more difficult to compare first-line trials due to diverging populations included in the respective studies. Concerning soft tissue sarcomas, the ESMO-MCBS was applicable for gastrointestinal stromal tumours(GIST) and ‘non-GIST’ soft tissue sarcoma with respect to data deriving from randomised studies. However, due to the heterogeneity of the disease itself and a limited number of controlled trials, limitations are noted. In ovarian cancer, the ESMO-MCBS supported the use of bevacizumab in high-risk patients. To date, there are only limited data for glioblastoma, head/neck cancer and urothelial cancer but whenever randomised trials were available, the ESMO-MCBS rating supported clinical decisions. Interestingly, nivolumab for salvage treatment of head/neck cancer rated extremely high.

Conclusion

The ESMO-MCBS scores supported our common treatment strategies and highlight the potential of new immunomodulatory drugs. Our results encourage further development of the ESMO-MCBS.

ESMO-MCBS
quality control
clinical benefit
metastatic disease

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Contributors: All authors fulfill the criteria for authorship and have read and approved the final version of the manuscript.

Competing interests: GWP has received honoraria for lectures by Merck Serono, Amgen, Bayer, Servier, Lilly, Celgene, Roche and Sanofi Aventis; TF has received honoraria or research grants from MSD, Merck, BMS, Pfizer, Sandoz and Astra Zeneca; MP has received research support from Boehringer-Ingelheim, GlaxoSmithKline, Merck Sharp & Dome and Roche and honoraria for lectures, consultation or advisory board participation from Bristol-Myers Squibb, Novartis, Gerson Lehrman Group (GLG), CMC Contrast, GlaxoSmithKline, Mundipharma, Roche and Astra Zeneca; GJL has received research support from Pierre Fabre and honoraria for lectures, consultation or advisory board participation from Bristol-Myers Squibb and Roche; TB has received personal fees from Amgen (lecture fee and advisory board), personal fees from Bayer (lecture fee and advisory board), personal fees from Eisai (lecture fee and advisory board), personal fees from Eli Lilly (lecture fee and advisory board), personal fees from Novartis (lecture fee and advisory board), personal fees from PharmaMar (lecture fee) and personal fees from Roche (lecture fee) outside the submitted work. CCZ has received honoraria by Bristol Myers-Squibb, Merck Sharp Dohme, Novartis, Roche, Astra Zeneca, Ariad and Imugene. All remaining authors have declared no conflict of interest.

Provenance and peer review: Not commissioned; externally peer reviewed.