Abstract LB-163: Comparing clinical value scores (NCCN, ASCO and ESMO) for TTFields treatment in glioblastoma

Abstract

Abstract Objective: To compare the tools of the National Comprehensive Cancer Network (NCCN), American Society of Clinical Oncology (ASCO) and the European Society for Medical Oncology (ESMO) for the assessment of the clinical value for Tumor treating fields (TTFields) in newly diagnosed Glioblastoma (GBM). Background: The effectiveness and safety of TTFields in newly diagnosed GBM was demonstrated by the final analysis of the randomized controlled EF-14 Trial (n=695). NCCN, ASCO and ESMO have developed tools to help inform physicians and policymakers about the clinical value of new cancer treatments in a standardized way. We report on the results of the tools for scoring the EF-14 trial data and comparatively discuss the results. Materials/Methods: The EF-14 Trial proved the effect of adding TTFields to maintenance temozolomide (TMZ) for newly diagnosed glioblastoma patients. The ESMO Magnitude of Clinical Benefit Scale (MCBS) and the ASCO Net Health Benefit (NHB) frameworks calculate a score for the clinical value of a cancer treatment. We applied both classifications to the EF-14 trial data. Quality of life data from the EF-14 Trial was also published and is included in the scoring. NCCN self reports “evidence blocks” which are assessed by clinician panels and were recently published for the first line treatment of newly diagnosed GBM. Results: Applying the ASCO framework to the EF-14 data resulted in a NHB score of 56. This scores is among the highest identified in the literature search. Applying the ESMO framework resulted in MCBS scores of A/5, these being the highest achievable scores for this framework. The ESMO framework valued the Health Related Quality of Life (HRQoL) gain during deterioration-free survival time with TTFields. The NCCN CNS panel designated TTFields as a category 1 recommendation in newly diagnosed GBM; the related NCCN evidence blocks support this recommendation. Conclusions: While the frameworks used by ASCO and ESMO focus on different aspects and definition of clinical value both suggest that adding TTFields to maintenance TMZ for newly diagnosed glioblastoma patients provides patients with significant clinical benefits. The high ESMO and ASCO scores are reflecting the fact, that treatment with TTFields extended progression free and overall survival without additional systemic toxicities. The NCCN evidence blocks together with the NCCN category 1 recommendation strongly support the use of Optune in newly diagnosed GBM Citation Format: Justin Kelly, Christina Proescholdt, Nicholas A. Blondin. Comparing clinical value scores (NCCN, ASCO and ESMO) for TTFields treatment in glioblastoma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr LB-163.