ASCO and the European Society for Medical Oncology (ESMO) published a joint analysis comparing the results of both organizations’ value frameworks in ASCO’s Journal of Clinical Oncology.1 The analysis found that the frameworks produce comparable measures of the clinical benefits of new therapies in approximately two-thirds of the more than 100 treatment comparisons that were examined. It also identified several factors that may contribute to discordant scores, revealing potential ways for both organizations to refine their frameworks in the future.
For this analysis, ASCO and ESMO researchers calculated the ASCO Value Framework’s Net Health Benefit and ESMO-Magnitude of Clinical Benefit Scale for 97 trials involving patients with advanced cancers, encompassing a total of 102 treatment comparisons. The authors used statistical analysis to establish scoring ranges for substantial and low benefit, finding that scores for the 2 frameworks fell within comparable ranges for 65 (64%) of the 102 treatment comparisons. Previously, published analyses from other authors found lower levels of concurrence between the frameworks on varied sets of clinical trials.
To refine both frameworks and bring their scores even closer to alignment, the joint assessment suggests four areas to address in subsequent versions of the frameworks, including:
- Revisiting the weights given to absolute and relative gains in survival
- Better accounting for limitations of progression-free survival as a surrogate for improved overall survival in the ASCO framework
- Revisiting methodology and terminology used to reward long-term gains in survival
- Considering refinements to scoring of toxicity, given advantages of each framework’s approach.
Both societies remain committed to refining their frameworks to increase their utility to physicians and improving the quality and value of patient care. ■
REFERENCE
1. Cherny NI, de Vries EGE, Dafni U, et al: Comparative assessment of clinical benefit using the ESMO-Magnitude of Clinical Benefit Scale version 1.1 and the ASCO Value Framework Net Health Benefit Score. J Clin Oncol. December 17, 2018 (early release online).
© 2019. American Society of Clinical Oncology. All rights reserved.
