Gribben John G, Bachy Emmanuel, Ray Markqayne, Krupsky Kathryn, Beusterien Kathleen, Kopenhafer Lewis, Beygi Sara, Best Timothy, Ball Graeme, Will Oliver, Palivela Madhu, Patel Anik, Ghione Paola
Barts Cancer Institute, Queen Mary University of London, London, United Kingdom.
Haematology Department, Hospices Civils de Lyon, Lyon, France.
Front Oncol. 2025 Jul 10;15:1589722. doi: 10.3389/fonc.2025.1589722. eCollection 2025.
The objectives of this study were to identify key treatment attributes that drive physician and patient preferences for second line (2L) and third line (3L) treatments in relapsed/refractory (R/R) follicular lymphoma (FL).
A multi- country, internet-based survey was administered to patients(N=195) with R/R FL and treating physicians (N=300) from the United States, United Kingdom, France, Germany, Brazil, and Japan. The survey included two discrete choice experiments - one for 2L and one for 3L treatment options - that prompted respondents to select their preferred option between two hypothetical treatment profiles varying on seven attributes associated with treatment for R/RFL: progression-free survival (PFS), overall survival (OS), serious adverse events (AE), cytokine release syndrome (CRS) events, neurological events, fatigue, and administration. Mean preference weights and relative attribute importance were estimated in each sample, overall and by country, using hierarchical Bayesian models. Physician estimates were also stratified by practice setting.
Treatment preferences for physicians and patients were most influenced by PFS. Beyond PFS, patients placed greater emphasis on the administration of medications, whereas physicians tended to focus more on five-year OS and toxicity profiles of agents. Preference for PFS above all other 2L and 3L treatment attributes was consistent for physicians, regardless of practice setting and country. However, patient treatment preferences varied by country.
These results offer key perspectives on how physicians and patients evaluate treatment options in 2L and 3L treatment settings; this information is essential for facilitating shared decision-making in an expanding, complex treatment landscape.
本研究的目的是确定在复发/难治性(R/R)滤泡性淋巴瘤(FL)中驱动医生和患者对二线(2L)和三线(3L)治疗偏好的关键治疗属性。
对来自美国、英国、法国、德国、巴西和日本的195例R/R FL患者和300名治疗医生进行了一项基于互联网的多国调查。该调查包括两个离散选择实验——一个针对2L治疗方案,一个针对3L治疗方案——促使受访者在两个假设的治疗方案之间选择他们偏好的方案,这两个方案在与R/R FL治疗相关的七个属性上有所不同:无进展生存期(PFS)、总生存期(OS)、严重不良事件(AE)、细胞因子释放综合征(CRS)事件、神经事件、疲劳和给药方式。使用分层贝叶斯模型在每个样本中总体和按国家估计平均偏好权重和相对属性重要性。医生的估计也按执业环境进行了分层。
医生和患者的治疗偏好受PFS影响最大。除PFS外,患者更强调药物的给药方式,而医生倾向于更关注药物的五年OS和毒性特征。无论执业环境和国家如何,医生对PFS高于所有其他2L和3L治疗属性的偏好都是一致的。然而,患者的治疗偏好因国家而异。
这些结果为医生和患者如何评估2L和3L治疗环境中的治疗选择提供了关键视角;这些信息对于在不断扩大、复杂的治疗格局中促进共同决策至关重要。