Clinical benefit of cancer drugs approved in Switzerland 2010-2019
It is unknown to what extent cancer drugs approved in Switzerland by the Swissmedic fulfil criteria of clinical benefit according to the European Society of Medical Oncology Magnitude of Clinical Benefit Scale version 1.1 (ESMO-MCBS), the American Society of Clinical Oncology Value Framework version...
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Published in | PloS one Vol. 17; no. 6; p. e0268545 |
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Main Authors | , , , , , , |
Format | Journal Article |
Language | English |
Published |
United States
Public Library of Science
10.06.2022
Public Library of Science (PLoS) |
Subjects | |
Online Access | Get full text |
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Summary: | It is unknown to what extent cancer drugs approved in Switzerland by the Swissmedic fulfil criteria of clinical benefit according to the European Society of Medical Oncology Magnitude of Clinical Benefit Scale version 1.1 (ESMO-MCBS), the American Society of Clinical Oncology Value Framework version 2 (ASCO-VF) and the Swiss OLUtool v2 (OLUtool).
An electronic search identified studies that led to marketing authorisations in Switzerland 2010-2019. Studies were evaluated according to ESMO-MCBS, ASCO-VF and OLUtool. Substantial benefit for ESMO-MCBS, was defined as a grade A or B for (neo)adjuvant intent and 4 or 5 for palliative intent. For ASCO-VF and OLUtool clinical benefit was defined as score ≥45 and A or B, respectively. Concordance between the frameworks was calculated with Cohen's Kappa (κ). Factors associated with clinical benefit were evaluated by logistic regression.
In the study period, 48 drugs were approved for 92 evaluable indications, based on 100 studies. Ratings for ESMO-MCBS, ASCO-VF and OLUtool could be performed for 100, 86, and 97 studies, respectively. Overall, 39 (39%), 44 (51%), 45 (46%) of the studies showed substantial clinical benefit according to ESMO-MCBS v1.1, ASCO-VF, OLUtool criteria, respectively. There was fair concordance between ESMO-MCBS and ASCO-VF in the palliative setting (κ = 0.31, P = 0.004) and moderate concordance between ESMO-MCBS and OLUtool (κ = 0.41, P<0.001). There was no significant concordance between ASCO-VF and OLUtool (κ = 0.18, P = 0.12). Factors associated with substantial clinical benefit in multivariable analysis were HRQoL benefit reported as secondary outcome for ESMO-MCBS and the ASCO-VF and blinded studies for OLUtool.
At the time of approval, only around half of the trials supporting marketing authorisation of recently approved cancer drugs in Switzerland meet the criteria for substantial clinical benefit when evaluated with ESMO-MCBS, ASCO-VF or OLUtool. There was at best only moderate concordance between the grading systems. |
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Competing Interests: I have read the journal’s policy and the authors of this manuscript have declared the following competing interests (and leave it to the judgement of the editor whether this is of relevant for the submitted work): Eitan Amir: reports personal fees for expert testimony from Genentech/Roche and an advisory role for Sandoz, Novartis and Exact Sciences. Ariadna Tibau: reports personal fee for travel grant from Pfizer and honoraria from Eisai, Roche and Novartis outside the submitted work. Arnoud J. Templeton: advisory board/consultancy: Astellas, MSD, BMS (institution), Janssen (institution), Sanofi (institution), Roche (institution); honoraria: Astellas, Sanofi; conference/travel support: Bayer, Sanofi, Janssen, Ipsen, Roche. This does not alter our adherence to PLOS ONE policies on sharing data and materials. All remaining authors have declared no conflict of interest. |
ISSN: | 1932-6203 1932-6203 |
DOI: | 10.1371/journal.pone.0268545 |