332P - Health state utility determination in advanced stage breast cancer patients

Date 29 September 2012
Event ESMO Congress 2012
Session Poster presentation I
Topics Bioethics, Legal, and Economic Issues
Breast Cancer, Metastatic
Presenter William Simons
Authors W.R. Simons
  • Eisai Value Maximization Systems, Eisai, Inc., 07677 - Woodcliff Lake/US



Quality-adjusted Time Without Symptoms of disease and Toxicity (Q-TWiST) survival analysis where time without disease progression is rewarded while time without disease progression but with toxicities is penalized by applying a utility weight is increasingly common in health technology assessments of cancer treatments. AIM: We assess women's preferences for health states specific to advanced stage breast cancer including a baseline diagnoses of ABC, treatment response, no treatment response but no disease progression, disease progression and hormonal therapy specific toxicities.


Using FACT-B quality of life data from a randomized clinical trial in ABC univariate statistics were obtained for each item for each health state without regard to treatment. These item scores were paired to the actual narrative in the FACT-B to construct health state narratives consisting of physical, social, emotional, functional well-being and additional concerns content domains. The order of the content domains was varied to prevent order bias. One hundred and nine peri- or post-menopausal women were recruited and interviewed by a single woman in their age group using visual analogue and standard gamble techniques. Univariate and multivariate analyses were performed to control for age, marital status, menopausal status and whether the interviewee has had breast cancer or any other cancer.


Of the 109 recruited 100 women completed the interview, mean age was 55.76 years, 64% were postmenopausal, 11% had breast cancer previously and 16% had another type of cancer previously. Multiple regressions results for the VAS scores yielded values of 51.8 (p < 0.01) for baseline ABC diagnosis, 82.5 (p < 0.01) for treatment response, 57.5 (p < 0.01) for no response no progression and 38.4 (p < 0.01) for disease progression. The SG results were 0.64 (p < 0.01), 0.76 (p < 0.01), 0.67 (p < 0.01), and 0.50 (p < 0.01), respectively. Women who previously had breast cancer related the health states consistently higher (p < 0.05) in the VAS and SG analyses. The trade-off between a chance of treatment response yet the possibility of toxicity yielded a utility score of 0.34 (p < 0.01).


These VAS and SG scores can be used to better assess women's preference for treatment options in ABC.


W.R. Simons: This research was conducted independent of Eisai Inc.