1364O_PR - The ESMO-Magnitude of Clinical Benefit Scale (MCBS) in rare tumor entities: A real life experience at the Medical University Vienna

Date 10 October 2016
Event ESMO 2016 Congress
Session Public health and health economics
Topics Bioethics, Legal, and Economic Issues
Presenter Barbara Kiesewetter
Citation Annals of Oncology (2016) 27 (6): 1-36. 10.1093/annonc/mdw435
Authors B. Kiesewetter, M. Raderer, C. Marosi, T. Brodowicz, G. Prager, M. Krainer, T. Fuereder, G.J. Locker, C.C. Zielinski
  • Medicine I, Clin. Div. Of Oncology And Comprehensive Cancer Center, Medizinische Universitaet Wien (Medical University of Vienna), 1090 - Vienna/AT

Abstract

Background

The ESMO-MCBS is a new tool to quantify the clinical benefit of a certain drug for the treatment of cancer. Recently, we have evaluated the practicability of the MCBS in daily practice of treating common tumor entities at our center. However, to date there is no experience of using the MCBS for rare tumors.

Methods

This study analyses the feasibility of the MCBS for rare tumor entities at the Clinical Division of Oncology, Medical University Vienna. We developed a 3-step approach to address this question. First, we retrospectively collected data to gain an overview on treatments in regular use. Second, we scored data with the MCBS, and third, evaluated results with the corresponding program directorships to assess the feasibility in a real-life context.

Results

We assessed data on neuroendocrine tumors (NET), glioblastoma, sarcomas, thyroid-, pancreatic-, ovarian-, head/neck- and urothelial cancer. The following results were obtained: 1) NET and thyroid cancer: Recently published trials are comparable in design and efficacy and the MCBS scores are consistent with the clinical benefit seen in practice. However, the MCBS added little information on the question of optimal sequencing except for differentiated thyroid cancer where prior treatment (TKI or not) suggests an algorithm. 2) Pancreatic cancer: only two major 1st-line trials are currently available and a direct comparison is difficult due to diverging populations. 3) Sarcomas: MCBS reflects well the situation of GIST and was useful for randomized data on non-GIST sarcoma, but MCBS practicability was limited in rare subtypes due to a lack of controlled trials. 4) Ovarian cancer: the MCBS supports the use of bevacizumab in high-risk patients. This is in line with our experience. To date, there is only limited data for glioblastoma, head/neck- and urothelial cancer. However, if randomized trials were available, the MCBS-rating supported clinical decisions particularly for novel compounds. A broad selection of analyzed data will be presented at the meeting.

Conclusions

The MCBS is a helpful tool for clinical practice in rare tumors, if randomized data are available. It supports treatment decisions based on the expected clinical benefit.

Clinical trial identification

Not applicable.

Legal entity responsible for the study

Department of Medicine I, Medical University of Vienna

Funding

Department of Medicine I, Medical University of Vienna

Disclosure

T. Brodowicz: All outside the submitted work: Personal fees from Roche (lecture fee), Amgen (lecture fee, advisory board), Bayer (lecture fee, advisory board), Novartis (lecture fee, advisory board), PharmaMar (lecture fee), Eisai (lecture fee, advisory board). G. Prager: Honoraria for lectures by Merck Serono, Amgen, Bayer, Servier, Lilly, Celgene, Roche, Sanofi Aventis. C.C. Zielinski: Honoraria for advisory boards by Bristol Myers-Squibb, AstraZeneca, Imugene, Roche All other authors have declared no conflicts of interest.