Patient preferences for attributes of tyrosine kinase inhibitor treatments for EGFR mutation-positive non-small-cell lung cancer

• Published in: Future oncology (London, England) England), 2019-12, Vol.15 (34), p.3895-3907
• Main Authors: Bridges, John Fp, la Cruz, Marie de, Pavilack, Melissa, Flood, Emuella, Janssen, Ellen M, Chehab, Nabil, Fernandes, Ancilla W
• Format: Article
• Language: English
• Subjects: Administration, Oral; Aged; Aged, 80 and over; Anemia; Cancer therapies; Carcinoma, Non-Small-Cell Lung - drug therapy; Carcinoma, Non-Small-Cell Lung - genetics; Carcinoma, Non-Small-Cell Lung - mortality; Chemotherapy; DCE; Diarrhea; Diarrhea - chemically induced; Diarrhea - diagnosis; Diarrhea - psychology; direct elicitation; EGFR; EGFR-TKIs; ErbB Receptors - antagonists & inhibitors; ErbB Receptors - genetics; Fatigue - chemically induced; Fatigue - diagnosis; Fatigue - psychology; Female; Humans; Interviews; Literature reviews; Lung cancer; Lung Neoplasms - drug therapy; Lung Neoplasms - genetics; Lung Neoplasms - mortality; Male; Metastasis; Middle Aged; Mutation; Nausea; Nausea - chemically induced; Nausea - diagnosis; Nausea - psychology; NSCLC; Oral administration; Patient Preference - psychology; Patient Preference - statistics & numerical data; patient preferences; Patients; Preferences; Progression-Free Survival; Protein Kinase Inhibitors - administration & dosage; Protein Kinase Inhibitors - adverse effects; Retrospective Studies; Severity of Illness Index; Surveys and Questionnaires - statistics & numerical data; Time Factors; treatment attributes; Vomiting - chemically induced; Vomiting - diagnosis; Vomiting - psychology
• ISSN: 1479-6694; 1744-8301
• DOI: 10.2217/fon-2019-0396

EGFR-tyrosine kinase inhibitors (TKIs) vary in efficacy, side effects (SEs) and dosing regimen. We explored EGFR-TKI treatment attribute preferences in EGFR mutation-positive metastatic non-small-cell lung cancer. Patients completed a survey utilizing preference elicitation methods: direct elicitation of four EGFR-TKI profiles describing progression-free survival (PFS), severe SE risk, administration; discrete choice experiment involving 12 choice tasks. 90 participated. The preferred profile (selected 89% of times) had the longest PFS (18 months) and the lowest severe SE risk (5%). Patients would need compensation with ≥three-times longer PFS for severe SEs. Patients would accept ≤7 months PFS reduction for oral treatments versus intravenous. Patients preferred longer PFS but were willing to accept reduced PFS for more favorable SEs and dosing convenience. EGFR-TKIs are drugs used to treat a type of non-small-cell lung cancer with a change (mutation) in a gene called . The way the drug is taken by patients, its effectiveness and side effects are different for each EGFR-TKI. 90 patients with non-small-cell lung cancer containing the EGFR mutation took part in our study. Patients completed an online survey to choose which EGFR-TKI treatment traits are most important to them. We found that patients prefer treatments that offer them longer lengths of time before their cancer worsens; however, patients are willing to accept shorter lengths of time before their cancer worsens if the treatment has fewer side effects and is easier to take.