Ornstein Moshe C, Rosenblatt Lisa C, Yin Xin, Del Tejo Viviana, Guttenplan Sarah B, Ejzykowicz Flavia, Beusterien Kathleen, Will Oliver, Mackie deMauri S, Skiles Grace, DeCongelio Marc
Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA.
Global HEOR Oncology, Bristol Myers Squibb, Princeton, NJ, USA.
Patient Prefer Adherence. 2024 Aug 15;18:1729-1739. doi: 10.2147/PPA.S460994. eCollection 2024.
The treatment landscape for advanced/metastatic renal cell carcinoma (aRCC) has evolved quickly with the introduction of immunotherapies as a first-line treatment option. This study examined the preferences of patients with aRCC to better understand the characteristics of preferred treatments and the tradeoffs patients are willing to make when choosing treatment.
An online, cross-sectional survey was conducted in the US from May to August 2022 with adult patients with aRCC. A discrete-choice experiment assessed treatment preferences for aRCC. Attributes were identified through literature review and qualitative interviews and included progression-free survival, survival time, objective response rate, duration of response, risk of serious side effects, quality of life (QoL), and treatment regimen.
Survey results from 299 patients with aRCC were analyzed. Patients had a mean age of 55.7 years, were primarily White (50.5%) and were evenly representative of males (49.8%) and females (48.8%). Improvements in all attributes influenced treatment choice. On average, increasing survival time from 10% to 55% was most important, followed by improvements in QoL (ie, from worsens a lot to improves) and improvements to treatment regimen convenience (ie, less frequent infusions). Risk of serious adverse events and increased progression-free time, objective response rate (ORR), and duration of response (DOR) were of lesser importance.
In this study, patients highlighted that improving survival time was the most important and that QoL is also an important consideration. Discussions during treatment decision-making may benefit from broader conversations around treatment characteristics, including impacts on QoL and convenience of the regimen.
随着免疫疗法作为一线治疗选择的引入，晚期/转移性肾细胞癌（aRCC）的治疗格局迅速演变。本研究调查了aRCC患者的偏好，以更好地了解首选治疗的特征以及患者在选择治疗时愿意做出的权衡。
2022年5月至8月在美国对成年aRCC患者进行了一项在线横断面调查。一项离散选择实验评估了aRCC的治疗偏好。通过文献综述和定性访谈确定了属性，包括无进展生存期、生存期、客观缓解率、缓解持续时间、严重副作用风险、生活质量（QoL）和治疗方案。
分析了299例aRCC患者的调查结果。患者的平均年龄为55.7岁，主要为白人（50.5%），男性（49.8%）和女性（48.8%）的代表性均衡。所有属性的改善都会影响治疗选择。平均而言，将生存期从10%提高到55%最为重要，其次是生活质量的改善（即从大幅恶化到改善）和治疗方案便利性的改善（即输注频率降低）。严重不良事件风险以及无进展时间延长、客观缓解率（ORR）和缓解持续时间（DOR）的重要性较低。
在本研究中，患者强调改善生存期是最重要的，生活质量也是一个重要的考虑因素。治疗决策过程中的讨论可能受益于围绕治疗特征的更广泛对话，包括对生活质量和治疗方案便利性的影响。
