The European Society for Medical Oncology Magnitude of Clinical Benefit Scale (ESMO-MCBS) applied to pivotal phase III randomized-controlled trials of tyrosine kinase inhibitors in first-line for advanced non-small cell lung cancer with activating epidermal growth factor receptor mutations.
To examine the magnitude of the clinical benefit from first-line tyrosine kinase inhibitors (TKIs) advanced non-small cell lung cancer (NSCLC) with activating epidermal growth factor receptor (EGFR)-mutations. Areas covered: The present evaluation was restricted to pivotal phase III RCTs in first-line for advanced NSCLC with activating EGFR-mutations. We have subsequently applied the European Society for Medical Oncology-Magnitude of Clinical Benefit Scale (ESMO-MCBS) to the above pivotal phase III RCTs, to derive a relative ranking of the magnitude of clinically meaningful benefit. Our study evaluated 8 phase III RCTs (including 1710 patients). The ESMO-MCBS reached high grade (grade 4) for all TKIs treatments with at least one phase III RCT for each TKI. Expert commentary: Combining pharmacological costs of drugs with the measure of efficacy, afatinib has the lowest difference in costs per month-PFS gained and a comparable high grade of magnitude of clinical benefit.
a Medical Oncology , Mater Salutis Hospital-AULSS , 21 della Regione Veneto, Legnago , Italy.
Jacopo
J
Giuliani
b Pathology , Mater Salutis Hospital-AULSS , 21 della Regione Veneto, Legnago , Italy.
Andrea
A
Remo
a Medical Oncology , Mater Salutis Hospital-AULSS , 21 della Regione Veneto, Legnago , Italy.
Andrea
A
Bonetti
D000077716:Afatinib; D000970:Antineoplastic Agents / Q000191:economics / Q000494:pharmacology / Q000627:therapeutic use; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000191:economics / Q000235:genetics; D017326:Clinical Trials, Phase III as Topic; D016527:Drug Costs; D066246:ErbB Receptors / Q000235:genetics; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000191:economics / Q000235:genetics; D009154:Mutation; D047428:Protein Kinase Inhibitors / Q000191:economics / Q000494:pharmacology / Q000627:therapeutic use*; D011799:Quinazolines / Q000191:economics / Q000494:pharmacology / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D047428:Protein Kinase Inhibitors; D011799:Quinazolines; D000077716:Afatinib; D066246:ErbB Receptors
Advanced non-small cell lung cancer; ESMO-MCBS; first-line therapy; randomized phase III trials; targeted agents