e14616 Background: Methodology to evaluate anti-cancer drugs in GI malgnancies was previoulsy reported. It has been estimated that the society would be willing to pay $50,000-$100,000 per life-year S gain (S Negrier et, 2007). Objectives: Design scoring model methodology to evaluate and grade anti-cancer drugs in NSCLC with emphasis on the association between between S, AEs, A and C. Methodology: 0S and AEs data were abstracted from J Douillard, R Herbert, Le Chevalier, C Mangeold, A Sandler, F Shepard, R Rossell and C Thienelt (2005–2008). A was graded in points (P) from 3 oral to zero daily injections. AEs: 4 (placebo) to 0 (fatalities) using CTCAE v 3.0. S gain (days,d) was calculated in a corrected ratio of S/360 (SR); Cost R: as C/d/s/$1500, divided by (A+ AEs), corrected and expressed as C scores. C in US $ was based on treating one patient for entire course,70 kg or 1.7/ m2. Using a grading scale from A to D, Survival > 360d, SR>10; C/d/s up to $63 and CR up to 4.2 were rated as (A+) while S< 15d, SR <0.42, C/d/s> $1500 and CR>100 as (D). Results: Examples shown in Table . Adj Cis + Vin after resection in stage II and III scored the highest SR and lowest CR with A+ rating. However, there was a lesser SR using the same combination in mNSCLC. OS markedly improved with Er and BV in 2nd-line. Addition of Cetuximab (Cet) to Cis and Vin demonstrated modest S gain at a much higher CR. Bevacizumab (BV) combined with Pac + Car improved OS over Pac + Car in 1st and 2nd lines at higher CR. Combination of BV, Cis and Gemcitabine demonstrated the lowest S, highest CR and D rating. Discussion: S and C were calculated as Ratios. C scores were based on the association of S with arbitrary but relative weights assigned to AEs and A. BV and Er improved OS in 2nd line, in contrast to phase III Beta study. Adjuvant Cis+Vin seems to be cost-effective. Increased CR was not necessarily associated with improved S. Grading of drugs varied depending on S or C. Higher C/d/s, increased AEs and cumbersome A resulted in higher C scores. Conclusions: SR, CR and possibly C scores might be advantageous in evaluation, grading and comparison of anti-cancer drugs. [Table: see text] No significant financial relationships to disclose.
