A study out of the Medical University of Vienna, Austria, one of Europe’s largest cancer centers, asserts that the European Society for Medical Oncology (ESMO) Magnitude of Clinical Benefit Scale (MCBS) is a reliable resource for the management of advanced or metastatic disease, and encourages its use in daily routine.
The ESMO-MCBS was designed to assess the therapeutic benefit of different cancer medicines and was first tested in a range of solid tumors during its initial development. However, while the tool was internally validated, it was not evaluated in daily practice until results of a study where the tool was used to assess well-established oncological treatment strategies from first-line to salvage treatment were recently published in the journal ESMO Open Cancer Horizons.
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In that study, researchers tested the MCBS using a three-steep approach: first, by collecting and analyzing retrospective data to gain an understanding of treatment in regular use; then, by scoring data using the MBSC; and finally, by having the ensuing results evaluated within corresponding programme directorships to assess feasibility in a real-life clinical context.
The tumor types evaluated in the study were metastatic or advanced breast cancer, lung cancer, colorectal cancer, gastric and gastro-oesophageal cancer, renal cell cancer, and prostate cancer. Researchers made the decision to exclude (neo) adjuvant data due to strong guidelines. They also assessed commonly applied oral anticancer drugs.
Overall, researchers found that the MCBS results were consistent with daily clinical practice in the majority of tumor types, but some shortcomings were noted. In the metastatic breast cancer and advanced lung cancer disease states, the level of clinical benefit for first-line treatment standards derived using the scale were reflected well in the real-life experience. However, use of the scale for targeted therapies and later lines of treatment did reveal limitations, where a lack of data may have lead to underestimates in overall survival for certain drugs.
Still, researchers concluded that the ESMO-MCBS is very much applicable for daily clinical practice of specialty practices providing tertiary referral care. The scale helps to support clinical decision-making that reflect well the daily experience. And although it does not include cost as a part of its evaluations, it might also support decision-making within socioeconomic contexts.
“…our Programme Directors feel confident to use the ESMO-MCBS,” said lead author of the study Barbara Kiesewetter, MD, Medical University of Vienna. "The ESMO-MCBS is very simple to use and we feel that it is going to prove to be a very important tool for daily clinical practice based on our study results. Clinicians can go back to the data when considering new treatments and use the ESMO-MCBS online forms to analyse what can be expected from a new approach."
