A Field Test of Major Value Frameworks in Chemotherapy of Nasopharyngeal Carcinoma-To Know, Then to Measure
- The European Society for Medical Oncology (ESMO) and the American Society of Clinical Oncology (ASCO) have developed frameworks to evaluate cancer treatments, particularly for nasopharyngeal carcinoma.
- A study compared these frameworks using data from 15 randomized controlled trials of systemic chemotherapies for nasopharyngeal carcinoma, selecting trials with significant outcome differences favoring the experimental group.
- The study highlighted under-reporting and inconsistent reporting of toxicities in the trials, which affects the assessment of treatment value.
- All trials met ESMO's high benefit criteria, but there were significant variations in ASCO scores, indicating inconsistencies in framework application.
- These findings suggest a need for improving the frameworks to ensure consistent and reliable assessment of cancer treatment benefits.
The goal of any cancer therapy is to help patients live longer, or live better, or both. In the clinic, oncologists, and patients need to discuss the balance of benefit and toxicity associated with different treatment options, to make the best decision for each patient. The European Society for Medical Oncology (ESMO) and the American Society of Clinical Oncology (ASCO) have proposed and updated frameworks to assess the value of cancer treatment options.
Nasopharyngeal carcinoma (NPC) is prevalent in Southern China, Southeast Asia, North Africa, the Middle East, and Alaska. Radiotherapy (RT) is the primary treatment for non-metastatic NPC. Multiple randomized controlled trials (RCTs) have shown that combining chemotherapy with RT improves outcome in loco-regionally advanced NPC. However, different sequences (induction, concurrent, adjuvant, and their combinations) and regimens of chemotherapy were used in these RCTs and controversy remains over which treatment option is optimal. In recurrent or metastatic NPC, chemotherapy is the mainstay of treatment and various regimens have been used in the clinic.
Recently, researchers have used the ESMO and ASCO frameworks to assess systemic therapies for cancers. However, to the best of our knowledge, no study has tested these frameworks in NPC. We applied the updated ESMO and ASCO value frameworks to RCTs investigating systemic chemotherapies in NPC.
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