Ailawadhi Sikander, Inocencio Timothy J, Mansfield Carol, Chintakayala Phani, Bussberg Cooper, Chi Lei, Harnett James, Kroog Glenn S, Rodriguez-Lorenc Karen, Ma Qiufei
Division of Hematology/Oncology, Mayo Clinic, Jacksonville, FL, USA.
Regeneron Pharmaceuticals, Inc., Tarrytown, NY, USA.
Future Oncol. 2025 Mar;21(7):853-865. doi: 10.1080/14796694.2025.2461430. Epub 2025 Feb 26.
To quantify patient preferences for attributes of novel treatments for triple-class-exposed (TCE) relapsed and/or refractory multiple myeloma (RRMM).
Using a discrete-choice experiment, we elicited preferences for 7 attributes: objective response rate (ORR), overall survival (OS), all-grade cytokine release syndrome risk, all-grade immune effector cell-associated neurotoxicity syndrome risk, serious infection risk (grade 3+), treatment administration, and initial hospitalization requirements.
OS was the most important attribute (conditional relative importance [CRI] 32.0% for a 24-month increase), followed by serious infection risk (CRI 17.3% for avoiding a 60% risk), initial hospitalization requirements (CRI 15.0% for avoiding 14 days of initial hospitalization), and ORR (CRI 13.7% for a 38% increase). Based on differences between relative preference weights, fewer initial hospitalization days when starting treatment and off-the-shelf (vs. chimeric antigen receptor T [CAR T] cell-like) options were significantly preferred.
Therapy decisions for patients with TCE RRMM should consider tradeoffs between efficacy, safety, and attributes related to treatment process and initial monitoring.
量化患者对三重暴露（TCE）复发和/或难治性多发性骨髓瘤（RRMM）新型治疗属性的偏好。
通过离散选择实验，我们引出了对7个属性的偏好：客观缓解率（ORR）、总生存期（OS）、所有级别细胞因子释放综合征风险、所有级别免疫效应细胞相关神经毒性综合征风险、严重感染风险（3级及以上）、治疗给药方式以及初始住院要求。
总生存期是最重要的属性（24个月增加的条件相对重要性[CRI]为32.0%），其次是严重感染风险（避免60%风险的CRI为17.3%）、初始住院要求（避免14天初始住院的CRI为15.0%）和客观缓解率（增加38%的CRI为13.7%）。基于相对偏好权重的差异，开始治疗时初始住院天数较少以及现成可用（与嵌合抗原受体T[CAR T]细胞样治疗相对）的方案更受显著偏好。
TCE RRMM患者的治疗决策应考虑疗效、安全性以及与治疗过程和初始监测相关属性之间的权衡。
