Clinical benefit of systemic treatment in patients with advanced pancreatic and gastrointestinal neuroendocrine tumours according to ESMO-MCBS and ASCO framework
| Autor: | W. W. de Herder, L. D. de Hosson, Y. Schuller, Annemiek M E Walenkamp, Heinz-Josef Klümpen, Wouter T Zandee, Margot E T Tesselaar, L. M. van Veenendaal |
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| Přispěvatelé: | Guided Treatment in Optimal Selected Cancer Patients (GUTS), Graduate School, CCA -Cancer Center Amsterdam, Oncology, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, Internal Medicine |
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Databases Factual ESMO-MCBS Health benefits Placebo Systemic therapy pancreatic and gastrointestinal DOUBLE-BLIND 03 medical and health sciences value EVEROLIMUS 0302 clinical medicine Stomach Neoplasms Internal medicine Intestinal Neoplasms ASCO medicine Humans QUALITY In patient 030212 general & internal medicine AMERICAN SOCIETY Grading (tumors) Gastrointestinal Neoplasms Randomized Controlled Trials as Topic Clinical Oncology Natural course Everolimus PHASE-3 TRIAL PLACEBO business.industry clinical benefit Hematology RADIANT-4 Pancreatic Neoplasms LAR Neuroendocrine Tumors Oncology 030220 oncology & carcinogenesis SURVIVAL neuroendocrine tumours business LUNG medicine.drug |
| Zdroj: | Annals of Oncology, 28(12), 3022-3027. Oxford University Press Annals of oncology, 28(12), 3022-3027. Oxford University Press Annals of Oncology, 28(12), 3022-3027. Elsevier Ltd. |
| ISSN: | 0923-7534 |
| DOI: | 10.1093/annonc/mdx547 |
| Popis: | Background: Assessment of clinical benefit of systemic treatments of rare diseases including gastroenteropancreatic neuroendocrine tumours (GEP-NET) is challenging. Recently several tools have been developed to grade the clinical benefit of cancer drugs. The European Society for Medical Oncology (ESMO) has developed the ESMO Magnitude of Clinical Benefit Scale (ESMO-MCBS). The American Society of Clinical Oncology (ASCO) has developed and revised the ASCO framework consisting of the Net Health Benefit (NHB) score juxtaposed against the costs of the treatment. In this review, we graded systemic treatments for GEP-NET patients with both frameworks.Methods: The electronic databases (PubMed and EMBASE) were searched for papers reporting comparative trials, conducted in adult GEP-NET patients in the English language. Papers were assessed according to the ESMO-MCBS and the NHB part of the ASCO revised Framework (NHB-ASCO-F) by four independent assessors, and discrepancies were discussed.Results: The search yielded 32 trials of which 6 were eligible for grading with the ESMO-MCBS resulting in scores of 2 or 3. Eight trials were eligible for grading with the NHB-ASCO-F, resulting in scores between 37.6 and 57.4. Trials that were not primary assessable by the tools were analysed separately. Consensus between assessors was reached in 68% of trials with the ESMO-MCBS and in 23% of trials with the NHB-ASCO-F.Conclusion: The currently used systemic treatments for GEP-NET patients had low scores according to the NHB-ASCO-F and none could be graded as meaningful clinical beneficial according to the ESMO-MCBS. Despite the low incidence, the heterogeneous patient population and relatively long natural course of NET, future studies on new treatment modalities should aim for high clinical benefit outcomes. |
| Databáze: | OpenAIRE |
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