Patients’ preferences for chemotherapy in non-small-cell lung cancer: A systematic review

Blinman, Prunella; Alam, Mahmood; Duric, V.; McLachlan, Sue‐Anne; Stockler, Martin R.

doi:10.1016/j.lungcan.2010.05.001

Cited by 55 publications

(65 citation statements)

References 33 publications

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“…Physicians should discuss patients' preferences when planning the treatment of patients with advanced NSCLC [16]. While several other papers have explored patient preferences for the benefit-risk trade-offs implicit in NSCLC treatment, they utilized methods that focused on very specific trade-offs, often using bidding games or simple discrete-choice methods [17][18][19][20][21][22][23].…”

Section: Introductionmentioning

confidence: 99%

Patients’ preferences for treatment outcomes for advanced non-small cell lung cancer: A conjoint analysis

et al. 2012

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Section: Introductionmentioning

confidence: 99%

Patients’ preferences for treatment outcomes for advanced non-small cell lung cancer: A conjoint analysis

et al. 2012

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“…In considering the potential survival, response rate, symptom relief and toxicity of chemotherapy, Japanese lung cancer patients were significantly more likely to accept invasive treatments for a potentially small benefit ["chance of cure", "response but not cure" and "symptom relief"] than the control group of patients with respiratory conditions alone [19]. A systematic review of four studies quantifying the survival benefits judged sufficient to make chemotherapy worthwhile found that smaller benefits were judged sufficient for NSCLC that was metastatic rather than locally advanced, broadly implying that smaller benefits may be sufficient when the baseline prognosis is worse [2] which may further widen the disparity between physician and patient perceptions of the value of chemotherapy. A large international study comparing patients' and physicians' assessments of the patients' attitudes towards treatment found that patients were much more likely to classify themselves as desiring a maximum extension of survival with high acceptance of toxicity than were physicians (60% vs 29%), while physicians were more likely to categories patients as prioritizing primary symptom relief than the patients themselves (29% vs 14%) [3].…”

Section: Perceptions Of Lung Cancer Patients: Balancing Risks and Benmentioning

confidence: 99%

“…Lung cancer is a common, costly and deadly disease [1,2]. Lung cancer has a poor prognosis predominately due to advanced stage of disease at presentation and associated co-morbidities [3,4].…”

Section: Introductionmentioning

confidence: 99%

“…Current evidence and clinical guidelines recommend chemotherapy for all stages of lung cancer, however in practice, the prescription of chemotherapy for lung cancer patients remains inconsistent and varies significantly both nationally and internationally [5][6][7]. Weighing the risks and benefits of therapy in lung cancer is an important consideration in developing the goals of care [2,8]. Understanding the views of physicians involved in the diagnosis and management of lung cancer and how these perspectives manifest in clinical decision making is important in addressing barriers to lung cancer treatment and the mismatch between current evidence and clinical practice in chemotherapy uptake.…”

Section: Introductionmentioning

confidence: 99%

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Decisions for lung cancer chemotherapy: the influence of physician and patient factors

Davidson

Jiwa

Goldsmith

et al. 2011

Support Care Cancer

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Results: Wide variability in perceptions of the value of chemotherapy in lung cancer is present among both physicians and patients. There is a mismatch in the degree patients and physicians weigh survival, such that patients value survival benefits highly whilst physicians strongly emphasize toxicity and associated symptoms. This lack of congruence between patients and clinicians is influenced by a range of factors and has implications for treatment decisions, long-term survival and quality of life in people affected by lung cancer. Conclusion:The divergence of treatment priorities indicates a need for improved communication strategies addressing the needs and concerns of both patients and clinicians. Patients should understand the benefits and risks of treatment options while clinicians can gain a greater awareness of factors influencing patients' decisions on treatments. Reflecting these perspectives and patient preferences for lung cancer treatment in clinical guidelines may improve clinician awareness.

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“…Shared decision-making requires that clinicians understand the preferences of their patients, as well as their own [8]. Studies of patients' preferences have shown they judge small survival benefits sufficient to make adjuvant chemotherapy worthwhile in a range of common cancers [9][10][11][12][13] Studies of clinicians have shown they judge larger benefits than patients necessary to make adjuvant chemotherapy worthwhile [13]. Studies of clinicians' preferences for adjuvant therapy in RCC have not been reported.…”

Section: Introductionmentioning

confidence: 99%

What Survival Benefits are Needed to Make Adjuvant Sorafenib Worthwhile After Resection of Intermediate- or High-Risk Renal Cell Carcinoma? Clinical Investigators’ Preferences in the SORCE Trial

Lawrence

Martin

Davis

et al. 2018

KCA

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Abstract.Background: Decisions about adjuvant therapy involve trade-offs between possible benefits and harms. Objective: We sought to determine the survival benefits that clinical investigators would judge as sufficient to warrant treatment with adjuvant sorafenib in the SORCE trial after nephrectomy for apparently localised renal cell carcinoma (RCC). Methods: A subset of clinical investigators in the SORCE trial completed a validated questionnaire that elicited the minimum survival benefits they judged sufficient to warrant one year of adjuvant sorafenib in scenarios with hypothetical baseline survival times of 5 years and 15 years, and baseline survival rates at 5 years of 65% and 85%. N.J. Lawrence et al. / Clinical Investigators' Preferences in SORCEResults: The 100 participating SORCE investigators had a median age of 42 years, and 74 were male. For one year of sorafenib versus no therapy, the median benefits in survival times the investigators judged sufficient to warrant treatment were an extra nine months beyond five years and an extra 12 months beyond 15 years; the median benefits in survival rates were an extra 5% beyond baseline survival rates of both 65% and 85% at five years. The patients recruited in the SORCE trial by these investigators judged smaller benefits sufficient to warrant adjuvant sorafenib for both survival rate scenarios (p ≤ 0.0001). The survival benefits the investigators judged sufficient to warrant one year of adjuvant therapy with sorafenib for RCC were similar to those of other clinicians considering three months of adjuvant chemotherapy for lung cancer, but smaller than those of clinicians considering six months of adjuvant chemotherapy for breast cancer. Conclusion: SORCE investigators judged larger benefits necessary to warrant adjuvant sorafenib than their patients. The benefits required by the investigators were similar or smaller than those other clinicians considered sufficient to warrant adjuvant chemotherapy for other cancers. Clinicians should recognise that their patients and colleagues may have preferences that differ from their own when considering the potential benefits and harms of adjuvant treatment.

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Patients’ preferences for chemotherapy in non-small-cell lung cancer: A systematic review

Cited by 55 publications

References 33 publications

Patients’ preferences for treatment outcomes for advanced non-small cell lung cancer: A conjoint analysis

Patients’ preferences for treatment outcomes for advanced non-small cell lung cancer: A conjoint analysis

Decisions for lung cancer chemotherapy: the influence of physician and patient factors

What Survival Benefits are Needed to Make Adjuvant Sorafenib Worthwhile After Resection of Intermediate- or High-Risk Renal Cell Carcinoma? Clinical Investigators’ Preferences in the SORCE Trial

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