Stella Mokiou (Cambridge, United Kingdom)
AstraZenecaAuthor Of 1 Presentation
70P - Factors influencing patient treatment decisions in early breast cancer (eBC): discrete choice experiment (DCE) findings (ID 85)
- Alessandra Gennari (Novara, Italy)
- Christian Jackisch (Offenbach am Main, Germany)
- Susan McCutcheon (Cambridge, United Kingdom)
- Emuella Flood (Gaithersburg, United States of America)
- Bhavna Murali (New York, United States of America)
- Xavier Guillaume (Paris, France)
- Oliver Will (Malverne, United States of America)
- Chikako Shimizu (Shinjuku-ku, Japan)
- Stella Mokiou (Cambridge, United Kingdom)
Abstract
Background
The emerging treatment paradigm in eBC, with new systemic therapies varying in efficacy, safety and conditions of use, creates a complex patient journey involving many inflection points with respect to treatment sequence, duration and response to initial therapy. We quantified patient preferences for attributes of different treatment pathways in eBC in Germany, Italy and Japan.
Methods
Patients diagnosed with HER2-negative stage I–IIIa breast cancer after 2014 who had undergone surgery and chemotherapy completed an online survey that included a DCE to assess attribute preferences of treatments for eBC. In 12 DCE tasks, patients indicated their preference between 2 hypothetical treatment profiles that varied in 8 attributes. Preference weights for each attribute level and relative attribute importance (RI) were estimated using hierarchical Bayesian modelling and calculated as a percentage based on the difference from the most to least favourable attribute level.
Results
Overall, 452 patients (Germany 151, Italy 151, Japan 150) participated; median (range) age was 48 (19–78) years; 80% were employed and most patients were satisfied (64%) or very satisfied (18%) with the prior therapy they received. Reducing risk of a serious side effect from 77% to 6% was most important (RI=27%), followed by increasing cancer-free survival at 3 years from 67% to 87% (RI=19%), decreasing treatment duration from 18 to 3 months (RI=16%) and reducing risk of nausea from 67% to 2% (RI=14%). Choice of a flexible vs fixed treatment plan was as important as reducing risk of neuropathy from 21% to 1% or fatigue from 41% to 3% (RI=7% for all). Choice of an oral vs intravenous regimen was least important (RI=5%). Some treatment attribute preferences differed by country; notably, efficacy was more important to patients in Japan.
Conclusions
Overall, this international cohort of patients regard the risk of serious side effects, treatment efficacy and treatment duration as highly important. Additionally, these patients would prefer a flexible treatment plan, with treatment escalation/de-escalation in line with response to initial therapy, over a fixed plan. This information may enhance physician–patient interactions in eBC.
Editorial acknowledgement
Editorial assistance was provided by Aaron Borg, PhD of PharmaGenesis Cambridge, Cambridge, UK, with funding from AstraZeneca and Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc.
Legal entity responsible for the study
AstraZeneca.
Funding
This study was funded by AstraZeneca and is part of an alliance between AstraZeneca and Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA.
Disclosure
A. Gennari: Financial Interests, Personal, Invited Speaker: Eisai; Financial Interests, Personal, Advisory Board: Eisai; Financial Interests, Personal, Advisory Board: Novartis; Financial Interests, Personal, Advisory Board: AstraZeneca; Financial Interests, Personal, Advisory Board: Roche; Financial Interests, Personal, Expert Testimony: Gentili; Financial Interests, Personal, Advisory Board: Daiichi Sankyo; Financial Interests, Personal, Advisory Board: Pfizer; Financial Interests, Personal, Advisory Board: Lilly; Financial Interests, Personal, Invited Speaker: Lilly. C. Jackisch: Financial Interests, Personal, Other, Honoraria, Consultancy, travel and accommodation expenses: AstraZeneca; Financial Interests, Personal, Other, Consultancy, travel and accommodation expenses: Lilly; Financial Interests, Personal, Leadership Role, Travel and accommodation expenses: Novartis; Financial Interests, Personal, Invited Speaker, Consultancy, travel and accommodation expenses: Roche. S. McCutcheon: Financial Interests, Personal, Full or part-time Employment: AstraZeneca; Financial Interests, Personal, Stocks/Shares: AstraZeneca. E. Flood: Financial Interests, Personal, Full or part-time Employment: AstraZeneca; Financial Interests, Personal, Stocks/Shares: AstraZeneca. B. Murali: Financial Interests, Personal, Full or part-time Employment: Cerner Enviza; Financial Interests, Personal, Other, Provides consultancy services to AstraZeneca as an employee of Cerner Enviza: AstraZeneca. X. Guillaume: Financial Interests, Personal, Full or part-time Employment: Cerner Enviza; Financial Interests, Personal, Other, Provides consultancy services to AstraZeneca as an employee of Cerner Enviza: AstraZeneca. O. Will: Financial Interests, Personal, Full or part-time Employment: Cerner Enviza; Financial Interests, Personal, Other, Provides consultancy services to AstraZeneca as an employee of Cerner Enviza: AstraZeneca. C. Shimizu: Financial Interests, Institutional, Research Grant: Chugai; Financial Interests, Personal, Other, Honoraria: Chugai; Financial Interests, Personal, Other, Honoraria: Eisai; Financial Interests, Personal, Other, Honoraria: Pfizer; Financial Interests, Institutional, Research Grant: AstraZeneca; Financial Interests, Institutional, Research Grant: Eli Lilly; Financial Interests, Institutional, Research Grant: Taiho. S. Mokiou: Financial Interests, Personal, Full or part-time Employment: AstraZeneca; Financial Interests, Personal, Stocks/Shares: AstraZeneca.