The European Society for Medical Oncology Magnitude of Clinical Benefit Scale (ESMO-MCBS) applied to pivotal phase III randomized-controlled trials of tyrosine kinase inhibitors in first-line for advanced non-small cell lung cancer with activating epidermal growth factor receptor mutations

ABSTRACT

Introduction: To examine the magnitude of the clinical benefit from first-line tyrosine kinase inhibitors (TKIs) advanced non-small cell lung cancer (NSCLC) with activating epidermal growth factor receptor (EGFR)-mutations.

Areas covered: The present evaluation was restricted to pivotal phase III RCTs in first-line for advanced NSCLC with activating EGFR-mutations. We have subsequently applied the European Society for Medical Oncology—Magnitude of Clinical Benefit Scale (ESMO-MCBS) to the above pivotal phase III RCTs, to derive a relative ranking of the magnitude of clinically meaningful benefit. Our study evaluated 8 phase III RCTs (including 1710 patients). The ESMO-MCBS reached high grade (grade 4) for all TKIs treatments with at least one phase III RCT for each TKI.

Expert commentary: Combining pharmacological costs of drugs with the measure of efficacy, afatinib has the lowest difference in costs per month-PFS gained and a comparable high grade of magnitude of clinical benefit.

KEYWORDS:

• Advanced non-small cell lung cancer
• randomized phase III trials
• first-line therapy
• targeted agents
• ESMO-MCBS

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Additional information

Funding

No funding was received for this special report