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ASCO: Agreement Lacking With ESMO on Most Effective Drugs

TUESDAY, June 6, 2017 -- There is little agreement between the American Society of Clinical Oncology (ASCO) Value Framework and European Society for Medical Oncology (ESMO) Magnitude of Clinical Benefit Scale, according to a study published online June 2 in The Lancet Oncology. The research was published to coincide with the annual meeting of the American Society of Clinical Oncology, held from June 2 to 6 in Chicago.

Joseph C. Del Paggio, M.D., from the University of Toronto, and colleagues examined 109 randomized controlled trials of systemic therapies in non-small-cell lung cancer, breast cancer, colorectal cancer, and pancreatic cancer published from Jan. 1, 2011, through Dec. 31, 2015. The authors assessed trial end points within the ASCO and ESMO frameworks at two time points three months apart to explore agreement between the approaches.

The researchers found that the ASCO scores ranged from 2 to 77, with a median score of 25. Forty-one trials (38 percent) met the benefits threshold in the ESMO framework. There was fair agreement between the frameworks (κ = 0.326). The ASCO benefit score was negatively correlated with monthly incremental drug costs among the 100 randomized trials for which drug costing data were available (P = 0.039). A lower incremental drug cost was seen for treatments that met ESMO benefit thresholds compared with those that did not meet thresholds ($2,981 versus $8,621; P = 0.018).

"The systems are designed to evaluate drugs' benefits, toxicity, and cost, to see whether it has any meaningful benefits for patients," according to a news release from The Lancet Oncology. "The data add to the growing realization that cost and benefit of new cancer drugs are not related, and illustrate the need for improvements to how cost-effectiveness is measured."

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Posted: June 2017

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