Dataset Information

Oncologic orphan drugs approved in the EU - do clinical trial data correspond with real-world effectiveness?

ABSTRACT:

Background

Evaluation of evidence for efficacy of orphan medicinal products (OMPs) for rare malignancies may be hampered by the use of tumor measurements instead of clinical endpoints. This may cause efficacy data to not always match effectiveness in the real-world. We investigated whether an efficacy-effectiveness gap exists for oncologic OMPs and aimed to identify which factors contribute to it. Also, the magnitude of the clinical efficacy of oncologic OMPs was evaluated.

Methods

We included all oncologic OMPs authorized in the European Union from 2000 to 2017. Pivotal studies were evaluated by means of the European Society for Medical Oncology - Magnitude of Clinical Benefit Scale (ESMO-MCBS). To estimate real-world effectiveness, a literature search was performed to identify post-marketing studies, of which data on overall survival (OS) were extracted. OS of the new OMP was compared with OS data of standard of care. An OS gain of ?3 months compared to pre-marketing data was considered clinically relevant.

Results

Twenty OMPs were included, of which 5 were authorized based on OS as a primary endpoint. 10 OMPs had post-marketing data available, of which 40% did not show a clinically relevant OS gain in the real world. All OMPs that were studied with OS as primary endpoint in the pivotal study had a clinically relevant OS gain in the real world. Furthermore, all OMPs that had a high ESMO-MCBS score and post-marketing data available, resulted in a clinically relevant OS gain in the real world.

Conclusions

Although the sample size is small, our results indicate an efficacy-effectiveness gap for oncologic OMPs exists. Significant changes in PFS do not always lead to an increased OS. The use of PFS may be justified, but validation of surrogate endpoints is needed.

SUBMITTER: Schuller Y

PROVIDER: S-EPMC6263065 | biostudies-literature | 2018 Nov

REPOSITORIES: biostudies-literature

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Publications

Oncologic orphan drugs approved in the EU - do clinical trial data correspond with real-world effectiveness?

Schuller Yvonne Y Biegstraaten Marieke M Hollak Carla E M CEM Klümpen Heinz-Josef HJ Gispen-de Wied Christine C CC Stoyanova-Beninska Violeta V

Orphanet journal of rare diseases 20181128 1

<h4>Background</h4>Evaluation of evidence for efficacy of orphan medicinal products (OMPs) for rare malignancies may be hampered by the use of tumor measurements instead of clinical endpoints. This may cause efficacy data to not always match effectiveness in the real-world. We investigated whether an efficacy-effectiveness gap exists for oncologic OMPs and aimed to identify which factors contribute to it. Also, the magnitude of the clinical efficacy of oncologic OMPs was evaluated.<h4>Methods</h ...[more]

PMID: 30486835

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Dataset Information

Oncologic orphan drugs approved in the EU - do clinical trial data correspond with real-world effectiveness?

Background

Methods

Results

Conclusions

Publications

Oncologic orphan drugs approved in the EU - do clinical trial data correspond with real-world effectiveness?

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