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PONE-D-21-28268Clinical Benefit of cancer drugs approved in Switzerland 2010 - 2019PLOS ONE

Dear Dr. Arnoud J Templeton,

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Academic Editor

PLOS ONE

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“I have read the journal's policy and the authors of this manuscript have declared the following competing interests (and leave it to the judgement of the editor whether this is of relevant for the submitted work):

Eitan Amir: reports personal fees for expert testimony from Genentech/Roche and an advisory role for Sandoz, Novartis and Exact Sciences.

Ariadna Tibau: reports personal fee for travel grant from Pfizer and honoraria from Eisai, Roche and Novartis outside the submitted work.

Arnoud J. Templeton: advisory board/consultancy: Astellas, MSD, BMS (institution), Janssen (institution), Sanofi (institution), Roche (institution); honoraria: Astellas, Sanofi; conference/travel support: Bayer, Sanofi, Janssen, Ipsen, Roche.

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Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

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Reviewer #1: The authors of the mentioned manuscript investigated the clinical benefit of different solid cancer drugs approved in Switzerland as measured by different published scoring systems. The article discusses a relevant topic and is written in an intelligible fashion, the statistics are performed correctly and the results are discussed in a differentiated manner.

Reviewer #2: The authors collected over 100 studies of approved cancer drugs

and compared 3 different published frameworks that

measure the clinical benefit and efficacy of the new treatments.

Based on the measures of the frameworks only half of the approved drugs showed

a substantial clinical benefit. The study also represents an impressive collection

of drug efficacy and outcome measures and is

a very valuable contribution.

1) The study performs a global assessment of all studies and subsets and

would benefit from including some more details which would dramatically improve

the reading and understanding of the paper.

For example the data collection is unclear,

a list/table of the data matrix of those 100 drugs with the described endpoints and

the inputs that were used for each of the 3 frameworks, e.g.

OS, PFS, DFS, RFS, ORR, toxicity, QoL outcomes and missing data and framework scoring.

2) Is also unclear which predictors were used and passed statistical

significance (section Statistical analysis/ Data Synthesis Scoring).

3) In addition it would make the paper more interesting if individual examples

could be briefly highlighted in the discussion section. For example a treatment with

exceptional improvement and one example that does

not show a substantial clinical benefit across the

three chosen frameworks. This could allow to understand the

shortcoming of the frameworks. For example would it be possible to make

a venn diagram showing the overlap of studies with clinical benefit

and without between the frameworks (e.g. Figure 2a)? (Section Substantial clinical benefit)

4) One shortcoming seems to be also that the paper (e.g. the discussion section) does

not consider to discuss findings of the literature.

Currently only a single citation is given in the discussion section (e.g. include similar studies

of other countries, new measures/guidelines, statistical approaches,

electronic health records, follow-up etc.).

other comments

Background.

check sentence. There are different validated tools ... of a cancer drugs

Discussion.

We found that only around half of the included 'trials' showed ...

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Reviewer #1: No

Reviewer #2: No

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Clinical Benefit of cancer drugs approved in Switzerland 2010 - 2019

PONE-D-21-28268R1

Dear Dr. Arnoud J Templeton,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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Kind regards,

Wen-Wei Sung, M.D., Ph.D.

Academic Editor

PLOS ONE