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从患者角度定量评估肺癌治疗方案的偏好:系统综述。

Quantitative Preferences for Lung Cancer Treatment from the Patients' Perspective: A Systematic Review.

机构信息

Chugai Pharmaceutical Co., Ltd., 1-1 Nihonbashi-Muromachi 2-Chome, Chuo-ku, Tokyo, Japan.

Laboratory of Pharmaceutical Regulation and Sciences, Graduate School of Pharmaceutical Sciences, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan.

出版信息

Patient. 2020 Oct;13(5):521-536. doi: 10.1007/s40271-020-00434-7.

Abstract

BACKGROUND

Regulatory agencies as well as private organizations pursue programs that advocate patient centricity and emphasize the importance of dialog with patients. Various methods are applied to elicit the preferences of patients regarding the aspects of treatment they lend more importance to. Decisions on treatment choices are critical to patients with lung cancer because of their poor prognosis and the serious trade-off between safety and efficacy in traditional cytotoxic chemotherapy.

METHODS

We conducted a systematic literature review of quantitative patient preference studies of patients with lung cancer. Our exhaustive search of MEDLINE, CINAHL, EMBASE, PLOS, and SpringerLink identified 15 relevant studies published from January 2000 to April 2020 that enabled us to assess the relative importance of treatment attributes according to lung cancer patients' perspective.

RESULTS

The literature review revealed that patients with lung cancer tend to place a higher weight on efficacy and quality of life (QoL) attributes than on other attributes. Overall survival was found to be the most important among the efficacy attributes. The consequences of adverse events seemed less important than the possible efficacy from therapies. The clinical utility of treatment, such as the route of administration, was generally not considered important. It remains inconclusive whether sociodemographic factors and/or medical history affect the relative importance of a patient's preference.

CONCLUSION

Our systematic review clarified that patients generally prefer a better efficacy profile to a better safety profile, which underscores the importance of improved benefits in anti-lung cancer drug development.

摘要

背景

监管机构和私营组织都推行以患者为中心的计划,并强调与患者进行对话的重要性。为了了解患者对治疗方面的偏好,各种方法都被应用,这些方面对患者来说更为重要。由于肺癌患者的预后较差,传统细胞毒性化疗的安全性和疗效之间存在严重的权衡,因此治疗选择的决策对他们来说至关重要。

方法

我们对肺癌患者的定量患者偏好研究进行了系统的文献回顾。我们对 MEDLINE、CINAHL、EMBASE、PLOS 和 SpringerLink 的全面搜索确定了 15 项相关研究,这些研究发表于 2000 年 1 月至 2020 年 4 月,使我们能够根据肺癌患者的观点评估治疗属性的相对重要性。

结果

文献综述表明,肺癌患者往往更看重疗效和生活质量(QoL)属性,而不是其他属性。总体生存被认为是疗效属性中最重要的。与治疗可能带来的疗效相比,不良事件的后果似乎不那么重要。治疗的临床实用性,如给药途径,通常被认为不重要。患者偏好的相对重要性是否受社会人口因素和/或病史影响,目前尚无定论。

结论

我们的系统综述阐明了患者通常更倾向于更好的疗效,而不是更好的安全性,这强调了在抗癌药物开发中提高效益的重要性。

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