Balancing benefits and risks in lung cancer therapies: patient preferences for lung cancer treatment alternatives

Oliveri, Serena; Lanzoni, Lucilla; Veldwijk, Jorien; Wit, G. Ardine de; Petrocchi, Serena; Janssens, Rik; Schoefs, Elise; Smith, Meredith Y.; Smith, I. P.; Nackaerts, Kristiaan; Vandevelde, Marie; Louis, Evelyne; Decaluwé, Herbert; Leyn, Paul De; Declerck, Hanne; Petrella, Francesco; Casiraghi, Monica; Galli, Giulia; Garassino, Marina Chiara; Girvalaki, Charis; Huys, Isabelle; Pravettoni, Gabriella

doi:10.3389/fpsyg.2023.1062830

Cited by 3 publications

(1 citation statement)

References 55 publications

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“…Our study is concordant with previous findings that the likelihood of undergoing GCT decreases with disease progression in NSCLC cases, was higher in stage I–II NSCLC than in stage III–IV NSCLC, this may be related to more direct patient selection and increased expectations of treatment outcomes. The majority of patients who did not undergo GCT presented with advanced disease, with quality of life (QOL) rather than survival likely to be an important consideration, and a previous study reported that patient preference for treatment was the most common reason for not seeking expert advice ( 48 ).…”

Section: Discussionmentioning

confidence: 99%

Three-year follow-up study reveals improved survival rate in NSCLC patients underwent guideline-concordant diagnosis and treatment

Mu,

Yang,

et al. 2024

Front. Oncol.

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BackgroundNo studies in China have assessed the guideline-concordance level of the first-course of non-small cell lung cancer (NSCLC) diagnosis and treatment and its relationship with survival. This study comprehensively assesses the current status of guideline-concordant diagnosis (GCD) and guideline-concordant treatment (GCT) of NSCLC in China and explores its impact on survival.MethodsFirst course diagnosis and treatment data for NSCLC patients in Liaoning, China in 2017 and 2018 (n=1828) were used and classified by whether they underwent GCD and GCT according to Chinese Society of Clinical Oncology (CSCO) guidelines. Pearson’s chi-squared test was used to determine unadjusted associations between categorical variables of interest. Logistic models were constructed to identify variables associated with GCD and GCT. Kaplan–Meier analysis and log-rank tests were used to estimate and compare 3-year survival rates. Multivariate Cox proportional risk models were constructed to assess the risk of cancer mortality associated with guideline-concordant diagnosis and treatment.ResultsOf the 1828 patients we studied, 48.1% underwent GCD, and 70.1% underwent GCT. The proportions of patients who underwent both GCD and GCT, GCD alone, GCT alone and neither GCD nor GCT were 36.7%, 11.4%, 33.5% and 18.4%, respectively. Patients in advanced stage and non-oncology hospitals were significantly less likely to undergo GCD and GCT. Compared with those who underwent neither GCD nor GCT, patients who underwent both GCD and GCT, GCD alone and GCT alone had 35.2%, 26.7% and 35.7% higher 3-year survival rates; the adjusted lung cancer mortality risk significantly decreased by 29% (adjusted hazard ratio[aHR], 0.71; 95% CI, 0.53–0.95), 29% (aHR, 0.71; 95% CI, 0.50–1.00) and 32% (aHR, 0.68; 95% CI, 0.51–0.90).ConclusionThe 3-year risk of death is expected to be reduced by 29% if patients with NSCLC undergo both GCD and GCT. There is a need to establish an oncology diagnosis and treatment data management platform in China to monitor, evaluate, and promote the use of clinical practice guidelines in healthcare settings.

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Section: Discussionmentioning

confidence: 99%

Three-year follow-up study reveals improved survival rate in NSCLC patients underwent guideline-concordant diagnosis and treatment

Mu,

Yang,

et al. 2024

Front. Oncol.

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Making Use of Technology to Improve Stated Preference Studies

Vass,

Boeri,

Shields

et al. 2024

Patient

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Patients’ considerations of time toxicity when assessing cancer treatments with marginal benefit

Gupta,

Brundage,

Galica

et al. 2024

The Oncologist

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Background Effective techniques for eliciting patients’ preferences regarding their own care, when treatment options offer marginal gains and different risks, is an important clinical need. We sought to evaluate the association between patients’ considerations of the time burdens of care (“time toxicity”) with decisions about hypothetical treatment options. Methods We conducted a secondary analysis of a multicenter, mixed-methods study that evaluated patients’ attitudes and preferences toward palliative-intent cancer treatments that delayed imaging progression-free survival (PFS) but did not improve overall survival (OS). We classified participants based on if they spontaneously volunteered one or more consideration of time burdens during qualitative interviews after treatment trade-off exercises. We compared the percentage of participants who opted for treatments with no PFS gain, some PFS gain, or who declined treatment regardless of PFS gain (in the absence of OS benefit). We conducted narrative analysis of themes related to time burdens. Results The study cohort included 100 participants with advanced cancer (55% women, 63% age > 60 years, 38% with gastrointestinal cancer, and 80% currently receiving cancer-directed treatment. Forty-six percent (46/100) spontaneously described time burdens as a factor they considered in making treatment decisions. Participants who mentioned time (vs not) had higher thresholds for PFS gains required for choosing additional treatments (P value .004). Participants who mentioned time were more likely to decline treatments with no OS benefit irrespective of the magnitude of PFS benefit (65%, vs 31%). On qualitative analysis, we found that time burdens are influenced by several treatment-related factors and have broad-ranging impact, and illustrate how patients’ experiences with time burdens and their preferences regarding time influence their decisions. Conclusions Almost half of participating patients spontaneously raised the issue of time burdens of cancer care when making hypothetical treatment decisions. These patients had notable differences in treatment preferences compared to those who did not mention considerations of time. Decision science researchers and clinicians should consider time burdens as an important attribute in research and in clinic.

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Balancing benefits and risks in lung cancer therapies: patient preferences for lung cancer treatment alternatives

Cited by 3 publications

References 55 publications

Three-year follow-up study reveals improved survival rate in NSCLC patients underwent guideline-concordant diagnosis and treatment

Three-year follow-up study reveals improved survival rate in NSCLC patients underwent guideline-concordant diagnosis and treatment

Making Use of Technology to Improve Stated Preference Studies

Patients’ considerations of time toxicity when assessing cancer treatments with marginal benefit

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