title: 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.
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.
authors.affiliation: Clinical Division of Oncology, Department of Medicine I , Comprehensive Cancer Center, Medical University of Vienna-General Hospital , Vienna , Austria.
authors.forename: Barbara
authors.initials: B
authors.lastname: Kiesewetter
authors.affiliation: Clinical Division of Oncology, Department of Medicine I , Comprehensive Cancer Center, Medical University of Vienna-General Hospital , Vienna , Austria.
authors.forename: Markus
authors.initials: M
authors.lastname: Raderer
authors.affiliation: Clinical Division of Oncology, Department of Medicine I , Comprehensive Cancer Center, Medical University of Vienna-General Hospital , Vienna , Austria.
authors.forename: Günther G
authors.initials: GG
authors.lastname: Steger
authors.affiliation: Clinical Division of Oncology, Department of Medicine I , Comprehensive Cancer Center, Medical University of Vienna-General Hospital , Vienna , Austria.
authors.forename: Rupert
authors.initials: R
authors.lastname: Bartsch
authors.affiliation: Clinical Division of Oncology, Department of Medicine I , Comprehensive Cancer Center, Medical University of Vienna-General Hospital , Vienna , Austria.
authors.forename: Robert
authors.initials: R
authors.lastname: Pirker
authors.affiliation: Clinical Division of Oncology, Department of Medicine I , Comprehensive Cancer Center, Medical University of Vienna-General Hospital , Vienna , Austria.
authors.forename: Sabine
authors.initials: S
authors.lastname: Zöchbauer-Müller
authors.affiliation: Clinical Division of Oncology, Department of Medicine I , Comprehensive Cancer Center, Medical University of Vienna-General Hospital , Vienna , Austria.
authors.forename: Gerald
authors.initials: G
authors.lastname: Prager
authors.affiliation: Clinical Division of Oncology, Department of Medicine I , Comprehensive Cancer Center, Medical University of Vienna-General Hospital , Vienna , Austria.
authors.forename: Michael
authors.initials: M
authors.lastname: Krainer
authors.affiliation: Clinical Division of Oncology, Department of Medicine I , Comprehensive Cancer Center, Medical University of Vienna-General Hospital , Vienna , Austria.
authors.forename: Matthias
authors.initials: M
authors.lastname: Preusser
authors.affiliation: Clinical Division of Oncology, Department of Medicine I , Comprehensive Cancer Center, Medical University of Vienna-General Hospital , Vienna , Austria.
authors.forename: Manuela
authors.initials: M
authors.lastname: Schmidinger
authors.affiliation: Clinical Division of Oncology, Department of Medicine I , Comprehensive Cancer Center, Medical University of Vienna-General Hospital , Vienna , Austria.
authors.forename: Christoph C
authors.initials: CC
authors.lastname: Zielinski
keywords: ESMO-MCBS; clinical benefit; metastatic disease; quality control