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The promise of ESCAT: a new system for evaluating cancer drug–target pairs

The ESMO Scale for Clinical Actionability of molecular Targets (ESCAT) will be useful as a common language to harmonize discussions in precision oncology and could also guide policy and reimbursement decisions, but it is far from perfect. Herein, we highlight how ESCAT can be further improved to increase its utility in clinical and policy decisions.

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References

  1. Szabo, L. Are we being misled about precision medicine? The New York Times https://www.nytimes.com/2018/09/11/opinion/cancer-genetic-testing-precision-medicine.html (2018).

  2. Gyawali, B. Point: the imprecise pursuit of precision medicine: are biomarkers to blame? J. Natl Compr. Canc. Netw. 15, 859–862 (2017).

    Article  Google Scholar 

  3. Levêque, D. Off-label use of targeted therapies in oncology. World J. Clin. Oncol. 7, 253–257 (2016).

    Article  Google Scholar 

  4. Mateo, J. et al. A framework to rank genomic alterations as targets for cancer precision medicine: the ESMO Scale for Clinical Actionability of molecular Targets (ESCAT). Ann. Oncol. 29, 1895–1902 (2018).

    Article  CAS  Google Scholar 

  5. Gyawali, B. The OlympiAD trial: who won the gold? Ecancermedicalscience 11, ed75 (2017).

    PubMed  PubMed Central  Google Scholar 

  6. Slamon, D. J. et al. Use of chemotherapy plus a monoclonal antibody against HER2 for metastatic breast cancer that overexpresses HER2. N. Engl. J. Med. 344, 783–792 (2001).

    Article  CAS  Google Scholar 

  7. Cherny, N. I. et al. ESMO-Magnitude of Clinical Benefit Scale version 1.1. Ann. Oncol. 28, 2340–2366 (2017).

    Article  CAS  Google Scholar 

  8. Swain, S. M. et al. Pertuzumab, trastuzumab, and docetaxel in HER2-positive metastatic breast cancer. N. Engl. J. Med. 372, 724–734 (2015).

    Article  CAS  Google Scholar 

  9. Chapman, P. B. et al. Vemurafenib in patients with BRAFV600 mutation-positive metastatic melanoma: final overall survival results of the randomized BRIM-3 study. Ann. Oncol. 28, 2581–2587 (2017).

    Article  CAS  Google Scholar 

  10. Soria, J.-C. et al. Osimertinib in untreated EGFR-mutated advanced non–small-cell lung cancer. N. Engl. J. Med. 378, 113–125 (2018).

    Article  CAS  Google Scholar 

  11. Drilon, A. et al. Efficacy of larotrectinib in TRK fusion–positive cancers in adults and children. N. Engl. J. Med. 378, 731–739 (2018).

    Article  CAS  Google Scholar 

Download references

Acknowledgements

The work of the authors is funded by the Laura and John Arnold Foundation. A.S.K. also receives grant support from the Harvard Program in Therapeutic Science and the Engelberg Foundation. The funders had no role in the design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript; and decision to submit the manuscript for publication.

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Correspondence to Bishal Gyawali.

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A.S.K. has received unrelated research funding from the FDA Division of Health Communication (2013–2016). B.G. declares no competing interests.

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Gyawali, B., Kesselheim, A.S. The promise of ESCAT: a new system for evaluating cancer drug–target pairs. Nat Rev Clin Oncol 16, 147–148 (2019). https://doi.org/10.1038/s41571-018-0110-3

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