Lung cancer clinicians’ preferences for adjuvant chemotherapy in non-small-cell lung cancer: What makes it worthwhile?

Blinman, Prunella; McLachlan, Sue‐Anne; Nowak, Anna K.; Duric, V.; Brown, Chris; Wright, Gavin; Millward, Michael; Fong, Kwun M.; Stockler, Martin R.

doi:10.1016/j.lungcan.2010.08.007

Cited by 16 publications

(17 citation statements)

References 20 publications

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“…Larger benefits were required to warrant a second and third year of adjuvant sorafenib, than one year. A B C D The characteristics of SORCE investigators were not associated with their preferences for adjuvant sorafenib in RCC, consistent with our previous studies of clinicians' preferences for adjuvant chemotherapy in lung and endometrial cancer [13,14].…”

Section: Discussionsupporting

confidence: 85%

“…3) [14]. The survival benefits judged sufficient to warrant one year of adjuvant sorafenib in RCC were similar to those judged sufficient to warrant three months of adjuvant chemotherapy in lung cancer (median benefits of nine months beyond five years, p = 0.95), but smaller than those judged sufficient to warrant six months of adjuvant chemotherapy in breast cancer and perhaps colon cancer (median benefits of nine months for RCC versus 12 months for breast and colon cancer beyond five years, p = 0.02 and 0.10 respectively).…”

Section: Resultsmentioning

confidence: 99%

“…We were also interested in comparing their judgements with those of their patients with RCC, and with those of clinicians considering adjuvant therapies for other cancers reported in our previous studies [14].…”

Section: Introductionmentioning

confidence: 99%

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What Survival Benefits are Needed to Make Adjuvant Sorafenib Worthwhile After Resection of Intermediate- or High-Risk Renal Cell Carcinoma? Clinical Investigators’ Preferences in the SORCE Trial

Lawrence

Martin

Davis

et al. 2018

KCA

Self Cite

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Abstract.Background: Decisions about adjuvant therapy involve trade-offs between possible benefits and harms. Objective: We sought to determine the survival benefits that clinical investigators would judge as sufficient to warrant treatment with adjuvant sorafenib in the SORCE trial after nephrectomy for apparently localised renal cell carcinoma (RCC). Methods: A subset of clinical investigators in the SORCE trial completed a validated questionnaire that elicited the minimum survival benefits they judged sufficient to warrant one year of adjuvant sorafenib in scenarios with hypothetical baseline survival times of 5 years and 15 years, and baseline survival rates at 5 years of 65% and 85%. N.J. Lawrence et al. / Clinical Investigators' Preferences in SORCEResults: The 100 participating SORCE investigators had a median age of 42 years, and 74 were male. For one year of sorafenib versus no therapy, the median benefits in survival times the investigators judged sufficient to warrant treatment were an extra nine months beyond five years and an extra 12 months beyond 15 years; the median benefits in survival rates were an extra 5% beyond baseline survival rates of both 65% and 85% at five years. The patients recruited in the SORCE trial by these investigators judged smaller benefits sufficient to warrant adjuvant sorafenib for both survival rate scenarios (p ≤ 0.0001). The survival benefits the investigators judged sufficient to warrant one year of adjuvant therapy with sorafenib for RCC were similar to those of other clinicians considering three months of adjuvant chemotherapy for lung cancer, but smaller than those of clinicians considering six months of adjuvant chemotherapy for breast cancer. Conclusion: SORCE investigators judged larger benefits necessary to warrant adjuvant sorafenib than their patients. The benefits required by the investigators were similar or smaller than those other clinicians considered sufficient to warrant adjuvant chemotherapy for other cancers. Clinicians should recognise that their patients and colleagues may have preferences that differ from their own when considering the potential benefits and harms of adjuvant treatment.

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Section: Discussionsupporting

confidence: 85%

Section: Resultsmentioning

confidence: 99%

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What Survival Benefits are Needed to Make Adjuvant Sorafenib Worthwhile After Resection of Intermediate- or High-Risk Renal Cell Carcinoma? Clinical Investigators’ Preferences in the SORCE Trial

Lawrence

Martin

Davis

et al. 2018

KCA

Self Cite

View full text Add to dashboard Cite

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“…Physicians should discuss patients' preferences when planning the treatment of patients with advanced NSCLC [16]. While several other papers have explored patient preferences for the benefit-risk trade-offs implicit in NSCLC treatment, they utilized methods that focused on very specific trade-offs, often using bidding games or simple discrete-choice methods [17][18][19][20][21][22][23].…”

Section: Introductionmentioning

confidence: 99%

Patients’ preferences for treatment outcomes for advanced non-small cell lung cancer: A conjoint analysis

et al. 2012

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“…Considering the illustration above for a patient with NSCLC, a previous study reported that most oncologists believe at least a 5% increase in 5-year survival is required to justify platinum-based adjuvant chemotherapy for this tumour [ 69 ] . The predicted improvement in 5-year survival of 4.2% for the patients with good prognosis may therefore not be considered sufficient to warrant chemotherapy, suggesting a change in management from that indicated by the 5.8% improvement in survival for patients before stratification with the imaging biomarker.…”

Section: Evaluative Framework For Prognostic Imaging Biomarkersmentioning

confidence: 99%

Incorporating prognostic imaging biomarkers into clinical practice

Law

Miles²

2013

Cancer Imaging

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A prognostic imaging biomarker can be defined as an imaging characteristic that is objectively measurable and provides information on the likely outcome of the cancer disease in an untreated individual and should be distinguished from predictive imaging biomarkers and imaging markers of response. A range of tumour characteristics of potential prognostic value can be measured using a variety imaging modalities. However, none has currently been adopted into routine clinical practice. This article considers key examples of emerging prognostic imaging biomarkers and proposes an evaluation framework that aims to demonstrate clinical efficacy and so support their introduction into the clinical arena. With appropriate validation within an established evaluation framework, prognostic imaging biomarkers have the potential to contribute to individualized cancer care, in some cases reducing the financial burden of expensive cancer treatments by facilitating their more rational use.

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Lung cancer clinicians’ preferences for adjuvant chemotherapy in non-small-cell lung cancer: What makes it worthwhile?

Cited by 16 publications

References 20 publications

What Survival Benefits are Needed to Make Adjuvant Sorafenib Worthwhile After Resection of Intermediate- or High-Risk Renal Cell Carcinoma? Clinical Investigators’ Preferences in the SORCE Trial

What Survival Benefits are Needed to Make Adjuvant Sorafenib Worthwhile After Resection of Intermediate- or High-Risk Renal Cell Carcinoma? Clinical Investigators’ Preferences in the SORCE Trial

Patients’ preferences for treatment outcomes for advanced non-small cell lung cancer: A conjoint analysis

Incorporating prognostic imaging biomarkers into clinical practice

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