Oxford Outcomes Ltd, Oxfordshire, UK.
Curr Med Res Opin. 2010 May;26(5):1091-6. doi: 10.1185/03007991003712258.
The aim of the study was to obtain United Kingdom societal preferences for receiving newly developed treatments for metastatic renal cell carcinoma.
Health states were developed based on a literature review and in-depth interviews with clinical experts. These states described the burden of both stable and progressive disease, and a variety of commonly encountered toxicities associated with first-line therapies (fatigue, diarrhoea, nausea/vomiting, mucositis, hand/foot syndrome, hypertension and anaemia). These states were further reviewed by additional clinicians and patients to ensure their validity. One hundred members of the general public rated the states using the time trade-off (TTO) methodology to determine health state utility.
Stable disease had a utility value of 0.795 whilst progressive disease demonstrated a significant decline with a value of 0.355. The range of toxicities showed a variable impact in line with their toxicity grading from fatigue grade I/II (0.751) to hand/foot syndrome grade III (0.469).
This study highlights the burden associated with a number of common toxicities encountered with current first-line mRCC treatments. Practical constraints coupled with the societal nature of the valuation exercise limited the amount of direct involvement by patients. However, these utility values should better permit the consideration of toxicity profiles in establishing the cost-effectiveness of future treatments.
本研究旨在了解英国社会对转移性肾细胞癌新疗法的偏好。
基于文献回顾和与临床专家的深入访谈，制定健康状况。这些状态描述了稳定和进展性疾病的负担，以及与一线治疗相关的各种常见毒性（疲劳、腹泻、恶心/呕吐、黏膜炎、手足综合征、高血压和贫血）。这些状态进一步由其他临床医生和患者进行了审查，以确保其有效性。100 名普通公众使用时间权衡（TTO）方法对这些状态进行了评分，以确定健康状态效用。
稳定疾病的效用值为 0.795，而进展性疾病的效用值显著下降，为 0.355。毒性范围与毒性分级相符，从疲劳 1/2 级（0.751）到手足综合征 3 级（0.469），表现出不同的影响。
本研究强调了目前一线 mRCC 治疗中常见毒性的负担。实际限制以及评估的社会性质限制了患者的直接参与程度。然而，这些效用值应能更好地考虑毒性特征，以确定未来治疗的成本效益。
