Background and Importance The European Society for Medical Oncology – Magnitude of Clinical Benefit Scale (ESMO-MCBS) is a tool designed to evaluate the clinical benefit of cancer treatments and can facilitate decision-making.
Aim and Objectives To analyse which of the cancer treatments started providing a substantial magnitude of clinical benefit according to the ESMO-MCBS. Know the prevalence of patients who have started some low benefit treatment. Assess whether the ESMO-MCBS could be a good indicator of the prescription’s quality.
Material and Methods Retrospective observational study that included all cancer treatments that were started in a tertiary care hospital from 03/01/22 to 06/30/22. The variables were collected: patient, treatment(s) prescribed, indication and ESMO-MCBS rating. The ESMO-MCBS score is considered in two different therapeutic settings: potentially curative treatments (A, B and C) and non-curative treatments (1 to 5). Substantial magnitude of clinical benefit was graded as A, B, 5 and 4. The variables calculated were:% of treatments with scores of greater clinical benefit and% of patients with at least one treatment of low benefit.
Results A total of 245 starts of treatment were reviewed, of which only 75 (31%) had an ESMO-MCBS rating. In 63% of the cases (n=47), treatments considered to be of relevant clinical benefit were started. Of these, 3 (6%) were treatments with curative intent (all level A) and 44 (94%) with palliative intent (level 4–5). Of those rated at level 4–5, pembrolizumab (n=14; 32%) in non-small-cell lung cancer and nivolumab (n=4; 9%) in head-neck cancer were predominant. 37% (n=28) of the patients started some low benefit treatment (level 1–3), being the most frequent atezolizumab (n=5; 18%) in small-cell lung cancer and nab-paclitaxel (n=5; 18%) in pancreatic adenocarcinoma.
Conclusion and Relevance More treatments with substantial benefit are started than those with less clinical benefit. All treatments with curative intent were level A. The non-curative setting presents a greater number of treatments with doubtful benefit. For most of the treatments classified as low benefit, there is no better therapeutic alternative, so we cannot assume that it is an indicator of poor prescription. Furthermore, we cannot classify most treatments because many of them do not have an ESMO-MCBS classification assigned.
Conflict of Interest No conflict of interest
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