Shah Manasee V, Solem Caitlyn T, Liao Anne, Bell Kelly F, Wang Yao, Yang Hongbo, Meng Yan, Ye Mingchen, Tapan Umit
GSK, Collegeville, PA, USA.
GSK, Bethesda, MD, USA.
Adv Ther. 2025 Aug 29. doi: 10.1007/s12325-025-03347-9.
Advanced/metastatic non-small cell lung cancer (a/mNSCLC) is associated with a poor prognosis. Although maintenance therapy after first-line (1L) induction treatment can extend survival, it may also present with drawbacks like risk of certain adverse events (AEs), underscoring the need for shared decision-making between patients and their treating physicians. This study aimed to quantify the extent to which maintenance treatment attributes impact the preferences of patients and physicians after 1L induction therapy for a/mNSCLC.
Eligible patients (aged ≥ 18 years in the UK and US) were diagnosed with a/mNSCLC and had stable disease with or responded to 1L induction therapy. Eligible physicians were licensed oncologists with ≥ 5 years' experience in a/mNSCLC treatment who had treated ≥ 20 such patients in the past year. Surveys assessed the patients' and physicians' perspectives regarding the current treatment landscape of a/mNSCLC, and a discrete choice experiment assessed their preferences regarding treatment characteristics. Data were collected using choice cards, designed to capture treatment attribute preferences including efficacy (progression-free survival [PFS] and overall survival [OS]), chance (risk) of new brain metastasis (BM), and selected AEs.
Among 34 UK and 48 US patients, the three most important treatment attributes (in order) were chance of new BM, OS, and risk of severe neutropenia. Among 51 UK and 50 US treating physicians, the 3 most important treatment attributes (in order) were OS, chance of new BM, and PFS.
In this real-world survey, OS and chance of new BM were the two most important maintenance treatment attributes for patients with a/mNSCLC and treating physicians. However, the risk of severe neutropenia carried greater relative importance, while PFS carried lesser relative importance, for patients than physicians. These results highlight the differing emphasis placed on attributes by patients and physicians when selecting maintenance treatment.
晚期/转移性非小细胞肺癌（a/mNSCLC）预后较差。尽管一线（1L）诱导治疗后的维持治疗可延长生存期，但也可能存在某些不良事件（AE）风险等缺点，这凸显了患者与其主治医生共同决策的必要性。本研究旨在量化维持治疗属性对a/mNSCLC患者和医生在1L诱导治疗后偏好的影响程度。
符合条件的患者（英国和美国年龄≥18岁）被诊断为a/mNSCLC，且疾病稳定或对1L诱导治疗有反应。符合条件的医生是在a/mNSCLC治疗方面有≥5年经验、过去一年治疗过≥20例此类患者的执业肿瘤学家。调查评估了患者和医生对a/mNSCLC当前治疗情况的看法，离散选择实验评估了他们对治疗特征的偏好。使用选择卡收集数据，选择卡旨在捕捉治疗属性偏好，包括疗效（无进展生存期[PFS]和总生存期[OS]）、新脑转移（BM）的几率（风险）以及选定的AE。
在34名英国患者和48名美国患者中，三个最重要的治疗属性（按顺序）是新BM的几率、OS和严重中性粒细胞减少的风险。在51名英国治疗医生和50名美国治疗医生中，三个最重要的治疗属性（按顺序）是OS、新BM的几率和PFS。
在这项真实世界调查中，OS和新BM的几率是a/mNSCLC患者和治疗医生最重要的两个维持治疗属性。然而，对于患者而言，严重中性粒细胞减少的风险相对更重要，而PFS的相对重要性则低于医生。这些结果凸显了患者和医生在选择维持治疗时对属性的不同侧重点。
