‘Many oncology medications on the market offer little help’

Shaare Zedek cancer expert initiates and helps develop scale to rate cancer drugs according to how much they help patients.

By JUDY SIEGEL-ITZKOVICH
Breast cancer ribbon (photo credit: INGIMAGE)
Breast cancer ribbon
(photo credit: INGIMAGE)
A leading Jerusalem oncologist and palliative medicine expert has initiated the development of a tool to help cancer physicians evaluate the most effective anti-cancer medications.
The tool – which gives a low ranking to the “many” drugs that are on the market but offer little help – includes scores for some 70 different cancer drugs.
“While it is known that the value of any new treatment is determined by the magnitude of its clinical benefit against its cost, to date there has not been a standard tool for grading such magnitude,” said Prof. Nathan Cherny, director of the cancer pain and palliative medicine service at Shaare Zedek Medical Center’s medical oncology department, who formulated the idea some years ago.
His idea was adopted by the European Society for Medical Oncology, which has just announced publication of the tool, called the ESMO Magnitude of Clinical Benefit Scale (MCBS).
“Many modern cancer drugs are of very little benefit to patients,” said Cherny.
“More and more medicines have been going on to the market with lower and lower levels of benefit.”
The ESMO-MCBS offers a rational, structured and consistent approach to “stratify” a drug’s clinically meaningful benefit, he continued. An article on the project and reporting the main results from a field testing of the scale conducted on 77 cancer medicines across 10 cancer types was published over the weekend in the journal Annals of Oncology and presented at the American Society of Clinical Oncology/ ESMO conference being held in Chicago.
“As the international organization committed to the interest of the oncology community at large, we are concerned about some anti-cancer medicines approved by the European Medicines Agency not being available or affordable to patients when prescribed,” said says ESMO president Rolf Stahel.
ESMO intends to apply the scale prospectively to new anti-cancer drugs that will be approved by the EMA. Drugs obtaining the highest scores on the scale will be highlighted in the ESMO Clinical Practice Guidelines, with the hope that they will be rapidly made available by health authorities across the European Union.
“In the absence of a standardized approach for grading the magnitude of clinical benefit, conclusions and recommendations derived from studies are often hotly disputed, and very modest incremental advances have often been presented, discussed and promoted as major advances or ‘breakthroughs,’” said Dr. Elisabeth G.E. de Vries, a medical oncologist at the University of Groningen in the Netherlands who is a member of the task force.
“Application of the scale will reduce the likelihood that statements of clinical benefit will be distorted by either overestimation or overstatement on one extreme or nihilism at the other,” she said.