We appreciated Dr Del Paggio’s continuing interest in the ESMO-MCBS [1]. In Form 2a of the ESMO-MCBS, which scales studies with evidence of benefit in overall survival, the ESMO-MCBS provides a 1 point bonus if the newer treatment is associated with fewer adverse events that undermine daily well-being. We acknowledge the inconsistency in the language used in Form 2a whereby statistical significance is referred to in the trigger question regarding toxicity (‘Are there statistically significantly less grade 3–4 toxicities impacting on daily well-being?’) but not in the adjustment criteria (‘Upgrade 1 level if improved quality of life and/or less grade 3–4 toxicities impacting daily well-being are shown’). It is understandable that this may contribute to confusion in applying the form.

中文翻译：

---

回复编辑的信“ESMO-MCBS 中的毒性调整：格式塔方法？” 德尔帕乔。

我们感谢 Del Paggio 博士对 ESMO-MCBS [1] 的持续兴趣。在 ESMO-MCBS 的表格 2a 中，该表格对研究进行了规模化，并提供了总体生存获益的证据，如果较新的治疗与较少的破坏日常健康的不良事件相关，则 ESMO-MCBS 提供 1 分奖励。我们承认表格 2a 中使用的语言不一致，即在关于毒性的触发问题中提到了统计显着性（“3-4 级毒性对日常健康的影响是否在统计学上显着减少？”），但在调整标准中没有（“如果显示生活质量提高和/或影响日常健康的 3-4 级毒性降低，则提升 1 级”）。可以理解的是，这可能会导致应用表格时出现混淆。