Abstract 159P
Background
This study quantified preferences for survival outcomes and risks associated with adjuvant treatment in early-stage NSCLC in order to understand patients’ and clinicians’ willingness to trade between treatment-related benefits and risks.
Methods
Patients with completely resected stage IB-IIIA NSCLC and treating clinicians in 13 countries across Asia, Europe, and the Americas completed an online discrete choice experiment (DCE). The DCE, informed by an evidence review and qualitative interviews, included 4 attributes: disease-free survival (DFS; 24, 38, 52, 66 months), postrecurrence survival (PRS; uncertain, 30, 50, 70 months), risk of grade 1–2 (1, 25, 50, 75%), and 3–4 (1, 5, 8, 10%) adverse events (AEs). DFS and PRS were presented individually and summed to represent overall survival. Each participant completed 8 experimentally designed choice tasks composed of two adjuvant treatment profiles and a no adjuvant treatment alternative. Marginal utilities were generated using a mixed logit model and relative attribute importance (RAI) scores were calculated.
Results
A total of 504 patients (P) and 515 clinicians (C) (Asia P: n=104, C: n=164; Europe P: n=149, C: n=251; Americas P: n=251, C: n=100) completed the survey. Mean patient age was 61 years, and most had adjuvant treatment experience (n=432, 86%). Most clinicians were oncologists (70%). DFS was the most important attribute of adjuvant treatment across respondent types (RAI=P: 35%, C: 51%), followed by PRS (RAI=P: 31%, C: 29%). The order of relative importance of AEs differed; patients placed more importance on reduced risk of grade 1–2 AEs (RAI=P: 23%, C: 7%), and clinicians placed more importance on reduced risk of grade 3–4 AEs (RAI=P: 11%, C: 14%). Among clinicians, RAI differed by geographic region, medical specialty, and patient volume. Among patients, RAI differed by geographic region, ECOG score, and adjuvant treatment experience.
Conclusions
In the context of early stage NSCLC, variation in the relative importance that patients’ and clinicians’ place on changes in survival and treatment-related risks suggest a role for shared decisionmaking and personalized approaches to treatment in the adjuvant setting.
Legal entity responsible for the study
AstraZeneca.
Funding
AstraZeneca.
Disclosure
C. Michaels-Igbokwe: Financial Interests, Institutional, Full or part-time Employment, Christine Michaels-Igbokwe is an employee of Evidera and holds stock in the company. Evidera received funding from AstraZeneca to conduct this study: Evidera. H. Collacott: Financial Interests, Institutional, Full or part-time Employment, Hannah Collacott is an employee of Evidera, who received funding from AstraZeneca to conduct this work: Evidera. A. Doldos: Financial Interests, Institutional, Full or part-time Employment, Anastasia Doldos is an employee of Evidera, who received funding from AstraZeneca to conduct this study: Evidera. M. Sandelin: Financial Interests, Institutional, Full or part-time Employment, Martin Sandelin is an employee of AstraZeneca and holds stock in the company: AstraZeneca. J. Pye: Financial Interests, Institutional, Full or part-time Employment, Joanna Pye is an employee of AstraZeneca: AstraZeneca. L. Servidio: Financial Interests, Institutional, Full or part-time Employment, Leslie Servidio is an employee of AstraZeneca and holds stock in the company: AstraZeneca. Y. Liang: Financial Interests, Institutional, Full or part-time Employment, Yi Liang is an employee of AstraZeneca and holds stock in the company: AstraZeneca. R.J. Salomonsen: Financial Interests, Institutional, Full or part-time Employment, Rachel Salomonsen is an employee of AstraZeneca and holds stock in the company: AstraZeneca.