Oncologist and Patient Preferences for Novel Agents in First-Line Treatment for Chronic Lymphocytic Leukemia: Commonalities and Disconnects

Le, Hannah; Ryan, Kellie; Wahlstrom, Svea K.; Maculaitis, Martine C.; Will, Oliver; Mulvihill, Emily; LeBlanc, Thomas W.

doi:10.2147/ppa.s289139

Cited by 9 publications

(22 citation statements)

References 25 publications

(14 reference statements)

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“…PFS was the most crucial attribute in a DCE directed only to patients, but the risk of adverse events was also substantial. 12 The primary importance given by clinicians to treatment efficacy in terms of PFS in our study was in agreement with results reported in a US study by Le et al, 11 although only first-line treatment was considered in that case. Also, efficacy was characterized by a very high RI, although second to cost, in a DCE experiment evaluating hematologists’ and pharmacists’ preferences for treatment selection for CLL, showing a consistent evaluation of this attribute from a clinical and service organization perspective.…”

Section: Discussionsupporting

confidence: 91%

“… 10 The relative weight of the risk of serious infections was identical in the 2 groups of our DCE. Le et al 11 also found that the risk of infections was important, yet not more than that of atrial fibrillation or treatment discontinuation due to adverse events. In our study, while the risk of atrial fibrillation was not relevant for clinicians compared with other treatment-related side effects, it was important for patients.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, the conjoint analysis may help to compare preferences of the different actors involved in CLL management, finding commonalities and inconsistencies, which may be valued in organizational perspectives. 10 , 11 , 14 …”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, a DCE study was carried out in the United States among oncologists and patients investigating preferences for attributes associated with a novel treatment for CLL. 11 The main driving factor was efficacy, in terms of progression-free survival (PFS), for both groups of respondents; the risk of atrial fibrillation, infection, and discontinuation due to adverse events were also considered important. 11 …”

Section: Introductionmentioning

confidence: 99%

“… 11 The main driving factor was efficacy, in terms of progression-free survival (PFS), for both groups of respondents; the risk of atrial fibrillation, infection, and discontinuation due to adverse events were also considered important. 11 …”

Section: Introductionmentioning

confidence: 99%

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What Are the Attributes Prioritized in the Choice of Therapy in Chronic Lymphocytic Leukemia? A Patient-physician Cross-matching Analysis of a Discrete Choice Experiment

et al. 2022

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Several treatment options are available for chronic lymphocytic leukemia (CLL) and, for this reason, treatment choice can result challenging after introducing oral targeted agents. This study aims at comparing patients’ and hematologists’ preferences for attributes of CLL treatments. An online cross-sectional survey has been delivered to clinicians and patients affected by CLL in Italy. A discrete choice experiment has been conducted so to estimate each attribute’s relative importance (RI) and assess the preference weight for each level of each attribute. An expert panel agreed on investigating the following attributes: progression-free survival (PFS) and measurable residual disease, route of administration/therapy duration and follow-up frequency, incidence of diarrhea (episodes/day), serious infections (grade 3 or 4), and atrial fibrillation. Overall, 746 patients and 109 clinicians accessed the survey, and 215 and 69, respectively, filled it in. The most important attributes were PFS (RI 30%) for hematologists and the risk of severe infections (RI 24%) for patients. Clinicians rated preference for maximum efficacy and lowest risk of severe infection very high (30%). Both patients and clinicians preferred oral administration while considering duration of therapy less relevant. The frequency of hospital appointments was negligible for patients, while clinicians preferred a quarterly frequency. Considering all attributes, diarrhea was weighted more by clinicians than by patients. Atrial fibrillation was not relevant for clinicians, while it was not negligible for patients. In conclusion, clinicians and patients favor an oral therapy, including continuous treatment, if associated with prolonged PFS, albeit with particular attention to the risk of serious infections.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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What Are the Attributes Prioritized in the Choice of Therapy in Chronic Lymphocytic Leukemia? A Patient-physician Cross-matching Analysis of a Discrete Choice Experiment

et al. 2022

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Patients' preferences for chronic lymphocytic leukemia treatment: The CHOICE study

Sportoletti,

Laurenti,

Chiarenza

et al. 2023

Hematological Oncology

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Chronic lymphocytic leukemia (CLL) therapies differ in efficacy, side effects, route, frequency, and duration of administration. We assessed patient preferences for treatment attributes and evaluated associations with disease stage, treatment line, and socio‐demographic characteristics in a cross sectional, observational study conducted at 16 Italian hematology centers. Study visits occurred between February and July 2020; 401 adult patients with CLL (201 Watch and Wait (W&W), 200 treated) participated in a discrete choice experiment (DCE), composed of 8 choices between pairs of treatment profiles with different levels of 5 attributes of currently available CLL treatments (length of response, route and duration of administration, risk of side effects including diarrhea, infections, or organ damage). Health‐related quality of life was assessed with the EQ‐5D‐5L, EORTC QLQ‐C30 and QLQ CLL‐16. Previously treated patients had longer disease duration (7 vs. 5 years), higher prevalence of serious comorbidities (45.5% vs. 36.2%) and high‐risk molecular markers (unmutated IGHV 55.6% vs. 17.1%; TP53 mutation 15.2% vs. 4.0%). Health‐related quality of life scores were similar between groups. In the DCE, W&W patients rated “possible occurrence of infections” highest (relative importance [RI] = 36.2%), followed by “treatment and relevant duration” (RI = 28.0%) and “progression‐free survival (PFS)” (RI = 16.9%). Previously treated patients rated “treatment and relevant duration” highest (RI = 33.3%), followed by “possible occurrence of infections” (RI = 28.8%), “possible occurrence of organ damage” (RI = 19.4%), and “PFS” (RI = 9.8%). Concern over infection was rated highest overall; unexpectedly PFS was not among the most important criteria in either group, suggesting that the first COVID‐19 pandemic wave may have influenced patient preferences and concerns about CLL therapy options.

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Patient Preferences in Targeted Pharmacotherapy for Cancers: A Systematic Review of Discrete Choice Experiments

Jiang

Ren

et al. 2022

PharmacoEconomics

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Background Targeted pharmacotherapy has been increasingly applied in cancer treatment due to its breakthroughs. However, the unmet needs of cancer patients are still significant, highlighting the urgency to investigate patient preferences. It is unclear how patients deliberate their choices between different aspects of targeted therapy, including cost, efficacy, and adverse events. Since discrete choice experiments (DCEs) have been widely applied to patient preference elicitation, we reviewed DCEs on targeted therapy for different cancers. We also synthesized evidence on the factors influencing patients' choices and their willingness-to-pay (WTP) for survival when treated by targeted therapy. Methods We searched databases, including PubMed, EMBASE and MEDLINE, up to August 16, 2022, supplemented by a reference screening. The attributes from the selected studies were categorized into three groups: outcomes, costs, and process. We also calculated the relative importance of attributes and WTP for survival whenever possible. The purpose, respondents, explanation, findings, significance (PREFS) checklist was used to evaluate the quality of the included DCE studies. Results The review identified 34 eligible studies from 13 countries covering 14 cancers, such as breast, ovarian, kidney, prostate, and skin cancers. It also reveals a rising trend of DCEs on this topic, as most studies were published after 2018. We found that patients placed higher weights on the outcome (e.g., overall survival) and cost attributes than on process attributes.

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Oncologist and Patient Preferences for Novel Agents in First-Line Treatment for Chronic Lymphocytic Leukemia: Commonalities and Disconnects

Cited by 9 publications

References 25 publications

What Are the Attributes Prioritized in the Choice of Therapy in Chronic Lymphocytic Leukemia? A Patient-physician Cross-matching Analysis of a Discrete Choice Experiment

What Are the Attributes Prioritized in the Choice of Therapy in Chronic Lymphocytic Leukemia? A Patient-physician Cross-matching Analysis of a Discrete Choice Experiment

Patients' preferences for chronic lymphocytic leukemia treatment: The CHOICE study

Patient Preferences in Targeted Pharmacotherapy for Cancers: A Systematic Review of Discrete Choice Experiments

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