Abstract
BACKGROUND: EviQ is an oncology treatment repository that provides a curated and accepted group of standard of care treatments in Australia. A standardized assessment of the clinical benefit of published EviQ protocols has not been undertaken. This study aims to describe the treatments accepted in routine use in a developed country, to evaluate the typical benefit of these protocols and to explore predictors of Magnitude of Clinical Benefit Scale (MCBS) substantive treatment benefit. METHODS: We graded solid-tumour protocols published on EviQ until 31 April 2022 with ESMO-MBCS version 1.1. Protocols were excluded if they functioned as duplicates of active protocols or were discontinued. We used the 'Evidence' section of the protocol to provide references. Logistic regression was used to evaluate predictive factors for clinical benefit. RESULTS: Of 432 EviQ protocols, 274 (63%) were deemed evaluable, with 87 (32%) curative and 187 (34%) palliative intent protocols. Overall, 134 (47%) protocols were of 'substantive benefit'. Seventy (80%) curative intent protocols were of 'substantive benefit' compared with 64 (34%) palliative intent protocols. Substantial treatment benefit was associated with curative intent [odds ratio (OR) 18.8, P < 0.001], tumour stream, and treatment modality. Using thoracic protocols as baseline, breast protocols were less likely to be beneficial (OR 0.29, P = 0.02), but other streams did not differ significantly. Compared with chemotherapy, checkpoint therapy predicted benefit (OR 4.35, P = 0.04) but other modalities did not differ significantly. CONCLUSION: Forty-eight percent of standard Australian medical oncology protocols provide substantial benefit, with the majority being curative intent. Other factors that predicted substantial benefit include checkpoint therapy and some tumour streams.