Purpose/Objective(s): The American Society of Clinical Oncology (ASCO) and European Society of Medical Oncology (ESMO) have developed frameworks to measure the clinical benefits of cancer therapies. We applied these frameworks to determine the clinical benefit of induction chemotherapy in locally advanced nasopharyngeal carcinoma treated with concurrent chemo-radiotherapy and to assess the associations between these two frameworks and between cost and each framework.

Materials/Methods: We searched various biomedical databases for randomized trials (RCTs) comparing induction chemotherapy (IC) plus concurrent chemo-radiotherapy (CCRT) with CCRT alone in locally advanced nasopharyngeal carcinoma (LANPC). We scored the clinical benefit of IC using the ASCO version 2 (v2) framework, and ESMO Magnitude of Clinical Benefit Scale (MCBS) version 1.1 (v1.1). The total drug costs for IC were derived from 2017 average wholesale prices. Spearman correlation was used to assess the association between these two frameworks and between cost and each framework.

Results: We identified six eligible RCTs. The benefit of IC was scored ESMO-MCBS grade A in three RCTs and grade C in other three RCTs. The median ASCO net health benefit (NHB) is 5.5 (range -25 to 56). The median total costs of IC (USD) is 1344 (range 239 to 1911). There was strong correlation between ASCO and ESMO framework (spearman’s rho = 0.89, p value (P) = 0.02). There was positive correlation between total drug costs and ASCO NHB (spearman’s rho = 0.38, P = 0.46) and between total drug costs and ESMO-MCBS grade (spearman’s rho = 0.68, P = 0.13).

Conclusion: The clinical benefit of adding IC in LANPC treated with CCRT was variable according to the ASCO and ESMO frameworks. There was a strong correlation between these two frameworks and positive correlations between framework outputs and drug costs.