Department of Dermatology and Phlebology, Vivantes Klinikum im Friedrichshain, Berlin, Germany.
Acta Derm Venereol. 2020 Mar 18;100(6):adv00083. doi: 10.2340/00015555-3422.
Treatment paradigms for advanced melanoma have changed fundamentally over recent years. A discrete choice experiment was performed to explore patient preferences regarding outcome (overall response rate, 2-year survival rate, progression-free survival, time to response, type of adverse events, probability of adverse event-related treatment discontinuation) and process attributes (frequency and route of administration, frequency of consultations) of modern treatments for melanoma. Mean preferences of 150 patients with melanoma stage IIC-IV were highest for overall response rate (relative importance score (RIS) 26.8) and 2-year survival (RIS 21.6), followed by type of adverse events (RIS 11.7) and probability of adverse event-related treatment discontinuation (RIS 9.2). Interest in overall response rate and 2-year survival declined with increasing age, whereas process attributes gained importance. Participants who had experienced treatment with immune checkpoint inhibitors valued overall response rate more highly and worried less about the type of adverse events. In conclusion, patients with advanced melanoma consider efficacy of treatment options most important, followed by safety, but preferences vary with individual and disease-related characteristics.
近年来,晚期黑色素瘤的治疗模式发生了根本性的变化。我们进行了一项离散选择实验,以探讨患者对现代黑色素瘤治疗方法的结局(总缓解率、2 年生存率、无进展生存期、反应时间、不良事件类型、因不良事件相关而停止治疗的概率)和过程属性(给药频率和途径、咨询频率)的偏好。150 名 IIC-IV 期黑色素瘤患者的平均偏好最高的是总缓解率(相对重要性评分(RIS)为 26.8)和 2 年生存率(RIS 为 21.6),其次是不良事件类型(RIS 为 11.7)和因不良事件相关而停止治疗的概率(RIS 为 9.2)。对总缓解率和 2 年生存率的兴趣随着年龄的增长而下降,而过程属性变得更加重要。接受过免疫检查点抑制剂治疗的参与者更看重总缓解率,对不良事件类型的担忧也更少。总之,晚期黑色素瘤患者认为治疗方案的疗效最重要,其次是安全性,但偏好因个体和疾病相关特征而异。