Original research
The European Society for Medical Oncology Magnitude of Clinical Benefit Scale in daily practice: a single institution, real-life experience at the Medical University of Vienna

https://doi.org/10.1136/esmoopen-2016-000066Get rights and content
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ABSTRACT

Background

The European Society for Medical Oncology (ESMO) Magnitude of Clinical Benefit Scale (MCBS) has been designed to stratify the therapeutic benefit of a certain drug registered for the treatment of cancer. However, though internally validated, this tool has not yet been evaluated for its feasibility in the daily practice of a major center of medical oncology.

Methods

The practicability of the MCBS for advanced oncological diseases at the Clinical Division of Oncology, Medical University of Vienna, which constitutes one of the largest oncological centres in Europe, was analysed in a three-step approach. First, retrospectively collected data were analysed to gain an overview of treatments in regular use. Second, data were scored by using the MCBS. Third, the ensuing results were evaluated within corresponding programme directorships to assess feasibility in a real-life clinical context.

Results

In the majority of tumour entities, the MCBS results reported earlier are consistent with daily clinical practice. Thus, in metastatic breast cancer or advanced lung cancer, there was a high level of clinical benefit for first-line treatment standards, and these results reflected well real-life experience. However, analyses based on the first version of the MCBS are limited if it comes to salvage treatment in tumour entities in which optimal sequencing of potential treatment options is of major importance, as in metastatic colorectal or renal cell cancer. In contrast to this, it is remarkable that certain novel therapies such as nivolumab assessed for heavily pretreated advanced renal cancer reached the highest level of clinical benefit due to prolongation in survival and a favourable toxicity profile. The MCBS clearly underlines the potential benefit of these compounds.

Conclusions

The MCBS is an excellent tool for daily clinical practice of a tertiary referral centre. It supports treatment decisions based on the clinical benefit to be expected from a novel approach such as immunotherapy in as yet untested indications.

ESMO-MCBS
quality control
clinical benefit
metastatic disease

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Competing interests: GP has received honoraria for lectures by Merck Serono, Amgen, Bayer, Servier, Lilly, Celgene, Roche and Sanofi Aventis. RP has received honoraria for lectures or advisory boards by AstraZeneca, Böhringer Ingelheim, Lilly, MSD, Pfizer, Roche and Synta. MP has received research support by Böhringer Ingelheim, GSK, MSD, Roche and honoraria by BMS, Novartis, CMC Contrast, GSK, Mundipharma and Roche. MS has received honoraria for lectures by Pfizer, BMS, Novartis, Roche and Astellas. CCZ has received honoraria for advisory boards by Bristol Myers-Squibb, AstraZeneca, Imugene and Roche. All remaining authors have declared no conflict of interest.

Provenance and peer review: Commissioned; internally peer reviewed.