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    Patient and Caregiver Preferences for First-Line Treatments of Metastatic Non-Small Cell Lung Cancer: A Discrete Choice Experiment.

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    Author
    Yong, Candice
    Cambron-Mellott, M Janelle
    Seal, Brian
    Will, Oliver
    Maculaitis, Martine C
    Clapp, Kelly
    Mulvihill, Emily
    Cotarla, Ion
    Mehra, Ranee
    Date
    2022-01-15
    Journal
    Patient Preference and aAdherence
    Publisher
    Dove Press
    Type
    Article
    
    Metadata
    Show full item record
    See at
    https://doi.org/10.2147/PPA.S338840
    Abstract
    Purpose: The approval of immune checkpoint inhibitors for metastatic non-small-cell lung carcinomas (mNSCLC) treatment has presented more care options. Therefore, it is important to identify the benefit-risk trade-offs patients and caregivers are willing to make among potential treatment options. This study quantified the preferences of patients and caregivers for attributes of mNSCLC treatment. Methods: Patients with mNSCLC and caregivers completed an online survey assessing preferences using a discrete choice experiment. Respondents chose between hypothetical treatment profiles, with varying levels for 7 attributes associated with first-line treatment, including overall survival (OS), progression-free survival, select adverse events (AEs), and regimen (caregivers). Hierarchical Bayesian modeling was used to estimate attribute-level preference weights. Results: Patients (n = 308) and caregivers (n = 166) most valued increasing OS from 11 to 30 months, followed by decreasing the risk of a serious AE (grade 3/4) that may lead to hospitalization from 70% to 18%. These attributes were over twice as important to both sets of respondents as the other attributes measured. Patients and caregivers would accept increases in the risks of a serious AE (grade 3/4) from 18% to 70% and all grades nausea from 10% to 69% if OS increased by 16.8 and 4.0 months, respectively. The least valued attributes were all grades of pneumonitis (patients) and all grades of skin rash (caregivers). Conclusion: Patients and caregivers are willing to make trade-offs between efficacy and toxicity and may require up to 1.5 years of increased OS to accept a higher risk of AEs. These results can provide guidance to oncologists when engaging in shared-decision making discussions. © 2022 Yong et al.
    Rights/Terms
    © 2022 Yong et al.
    Keyword
    immune checkpoint inhibitors
    metastases
    non-small-cell lung carcinomas
    overall survival
    patient preference
    toxicities
    Identifier to cite or link to this item
    http://hdl.handle.net/10713/17902
    ae974a485f413a2113503eed53cd6c53
    10.2147/PPA.S338840
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