Patient preferences for maintenance PARP inhibitor therapy in ovarian cancer treatment
To measure preferences of women with ovarian cancer regarding risks, side effects, costs and benefits afforded by maintenance therapy (MT) with a poly ADP ribose polymerase (PARP) inhibitor. A discrete-choice experiment elicited preferences of women with ovarian cancer regarding 6 attributes (levels...
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| Veröffentlicht in: | Gynecologic oncology 2020-03, Vol.156 (3), p.561-567 |
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| creator | Havrilesky, Laura J. Lim, Stephanie Ehrisman, Jessie A. Lorenzo, Amelia Alvarez Secord, Angeles Yang, Jui-Chen Johnson, F. Reed Gonzalez, Juan Marcos Reed, Shelby D. |
| description | To measure preferences of women with ovarian cancer regarding risks, side effects, costs and benefits afforded by maintenance therapy (MT) with a poly ADP ribose polymerase (PARP) inhibitor.
A discrete-choice experiment elicited preferences of women with ovarian cancer regarding 6 attributes (levels in parentheses) relevant to decisions for MT versus treatment break: (1) overall survival (OS; 36, 38, 42 months); (2) progression-free survival (PFS; 15, 17, 21 months); (3) nausea (none, mild, moderate); (4) fatigue (none, mild, moderate); (5) probability of death from myelodysplastic syndrome/acute myelogenous leukemia (MDS/AML; 0% to 10%); (6) monthly out-of-pocket cost ($0 to $1000). Participants chose between 2 variable MT scenarios and a static scenario representing treatment break, with multiple iterations. Random-parameters logit regression was applied to model choices as a function of attribute levels.
95 eligible participants completed the survey; mean age was 62, 48% had recurrence, and 17% were ever-PARP inhibitor users. Participants valued OS (average importance weight 24.5 out of 100) and monthly costs (24.6) most highly, followed by risk of death from MDS/AML (17.9), nausea (14.7), PFS (10.5) and fatigue (7.8). Participants would accept 5% risk of MDS/AML if treatment provided 2.2 months additional OS or 4.8 months PFS. Participants would require gains of 2.6 months PFS to accept mild treatment-related fatigue and 4.4 months to accept mild nausea.
When considering MT, women with ovarian cancer are most motivated by gains in OS. Women expect at least 3–4 months of PFS benefit to bear mild side effects of treatment.
•A survey was conducted to elicit the preferences of women with ovarian cancer for risks and benefits of PARP inhibitors.•Overall survival benefit and anticipated out of pocket costs most highly influenced women's choices.•Women expected at least 3–4 months of PFS in exchange for minimal side effects from taking a PARP inhibitor. |
| doi_str_mv | 10.1016/j.ygyno.2020.01.026 |
| format | Article |
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A discrete-choice experiment elicited preferences of women with ovarian cancer regarding 6 attributes (levels in parentheses) relevant to decisions for MT versus treatment break: (1) overall survival (OS; 36, 38, 42 months); (2) progression-free survival (PFS; 15, 17, 21 months); (3) nausea (none, mild, moderate); (4) fatigue (none, mild, moderate); (5) probability of death from myelodysplastic syndrome/acute myelogenous leukemia (MDS/AML; 0% to 10%); (6) monthly out-of-pocket cost ($0 to $1000). Participants chose between 2 variable MT scenarios and a static scenario representing treatment break, with multiple iterations. Random-parameters logit regression was applied to model choices as a function of attribute levels.
95 eligible participants completed the survey; mean age was 62, 48% had recurrence, and 17% were ever-PARP inhibitor users. Participants valued OS (average importance weight 24.5 out of 100) and monthly costs (24.6) most highly, followed by risk of death from MDS/AML (17.9), nausea (14.7), PFS (10.5) and fatigue (7.8). Participants would accept 5% risk of MDS/AML if treatment provided 2.2 months additional OS or 4.8 months PFS. Participants would require gains of 2.6 months PFS to accept mild treatment-related fatigue and 4.4 months to accept mild nausea.
When considering MT, women with ovarian cancer are most motivated by gains in OS. Women expect at least 3–4 months of PFS benefit to bear mild side effects of treatment.
•A survey was conducted to elicit the preferences of women with ovarian cancer for risks and benefits of PARP inhibitors.•Overall survival benefit and anticipated out of pocket costs most highly influenced women's choices.•Women expected at least 3–4 months of PFS in exchange for minimal side effects from taking a PARP inhibitor.</description><identifier>ISSN: 0090-8258</identifier><identifier>EISSN: 1095-6859</identifier><identifier>DOI: 10.1016/j.ygyno.2020.01.026</identifier><identifier>PMID: 31982178</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Benefit ; Cost ; Maintenance therapy ; PARP inhibitors ; Patient preferences ; Risk</subject><ispartof>Gynecologic oncology, 2020-03, Vol.156 (3), p.561-567</ispartof><rights>2020 Elsevier Inc.</rights><rights>Copyright © 2020 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c359t-2873e97ccd550fdbeff61f5e90e292f885af51de71e592ec24c4923f2526fe063</citedby><cites>FETCH-LOGICAL-c359t-2873e97ccd550fdbeff61f5e90e292f885af51de71e592ec24c4923f2526fe063</cites><orcidid>0000-0002-4259-5992</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.ygyno.2020.01.026$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3548,27923,27924,45994</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31982178$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Havrilesky, Laura J.</creatorcontrib><creatorcontrib>Lim, Stephanie</creatorcontrib><creatorcontrib>Ehrisman, Jessie A.</creatorcontrib><creatorcontrib>Lorenzo, Amelia</creatorcontrib><creatorcontrib>Alvarez Secord, Angeles</creatorcontrib><creatorcontrib>Yang, Jui-Chen</creatorcontrib><creatorcontrib>Johnson, F. Reed</creatorcontrib><creatorcontrib>Gonzalez, Juan Marcos</creatorcontrib><creatorcontrib>Reed, Shelby D.</creatorcontrib><title>Patient preferences for maintenance PARP inhibitor therapy in ovarian cancer treatment</title><title>Gynecologic oncology</title><addtitle>Gynecol Oncol</addtitle><description>To measure preferences of women with ovarian cancer regarding risks, side effects, costs and benefits afforded by maintenance therapy (MT) with a poly ADP ribose polymerase (PARP) inhibitor.
A discrete-choice experiment elicited preferences of women with ovarian cancer regarding 6 attributes (levels in parentheses) relevant to decisions for MT versus treatment break: (1) overall survival (OS; 36, 38, 42 months); (2) progression-free survival (PFS; 15, 17, 21 months); (3) nausea (none, mild, moderate); (4) fatigue (none, mild, moderate); (5) probability of death from myelodysplastic syndrome/acute myelogenous leukemia (MDS/AML; 0% to 10%); (6) monthly out-of-pocket cost ($0 to $1000). Participants chose between 2 variable MT scenarios and a static scenario representing treatment break, with multiple iterations. Random-parameters logit regression was applied to model choices as a function of attribute levels.
95 eligible participants completed the survey; mean age was 62, 48% had recurrence, and 17% were ever-PARP inhibitor users. Participants valued OS (average importance weight 24.5 out of 100) and monthly costs (24.6) most highly, followed by risk of death from MDS/AML (17.9), nausea (14.7), PFS (10.5) and fatigue (7.8). Participants would accept 5% risk of MDS/AML if treatment provided 2.2 months additional OS or 4.8 months PFS. Participants would require gains of 2.6 months PFS to accept mild treatment-related fatigue and 4.4 months to accept mild nausea.
When considering MT, women with ovarian cancer are most motivated by gains in OS. Women expect at least 3–4 months of PFS benefit to bear mild side effects of treatment.
•A survey was conducted to elicit the preferences of women with ovarian cancer for risks and benefits of PARP inhibitors.•Overall survival benefit and anticipated out of pocket costs most highly influenced women's choices.•Women expected at least 3–4 months of PFS in exchange for minimal side effects from taking a PARP inhibitor.</description><subject>Benefit</subject><subject>Cost</subject><subject>Maintenance therapy</subject><subject>PARP inhibitors</subject><subject>Patient preferences</subject><subject>Risk</subject><issn>0090-8258</issn><issn>1095-6859</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp9kE1LAzEQhoMoWqu_QJA9etl1km12k4OHIn5BwSLqNaTZiU3p7tYkLfTfm1r16Glg5pkZ3oeQCwoFBVpdL4rtx7brCwYMCqAFsOqADChInleCy0MyAJCQC8bFCTkNYQEAJVB2TE5KKgWjtRiQ96mODruYrTxa9NgZDJntfdZq10XsdGpk0_HLNHPd3M1cTKM4R69X29TJ-o32TneZ2XFp4lHHNp07I0dWLwOe_9Qhebu_e719zCfPD0-340luSi5jzkRdoqyNaTgH28zQ2opajhKQSWaF4Npy2mBNkUuGho3MSLLSMs4qi1CVQ3K1v7vy_ecaQ1StCwaXS91hvw6KlaOKSUGhTmi5R43vQ0hp1cq7VvutoqB2QtVCfQtVO6EKqEpC09blz4P1rMXmb-fXYAJu9gCmmBuHXgXjdhob59FE1fTu3wdf_ZyJGQ</recordid><startdate>202003</startdate><enddate>202003</enddate><creator>Havrilesky, Laura J.</creator><creator>Lim, Stephanie</creator><creator>Ehrisman, Jessie A.</creator><creator>Lorenzo, Amelia</creator><creator>Alvarez Secord, Angeles</creator><creator>Yang, Jui-Chen</creator><creator>Johnson, F. Reed</creator><creator>Gonzalez, Juan Marcos</creator><creator>Reed, Shelby D.</creator><general>Elsevier Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-4259-5992</orcidid></search><sort><creationdate>202003</creationdate><title>Patient preferences for maintenance PARP inhibitor therapy in ovarian cancer treatment</title><author>Havrilesky, Laura J. ; Lim, Stephanie ; Ehrisman, Jessie A. ; Lorenzo, Amelia ; Alvarez Secord, Angeles ; Yang, Jui-Chen ; Johnson, F. Reed ; Gonzalez, Juan Marcos ; Reed, Shelby D.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c359t-2873e97ccd550fdbeff61f5e90e292f885af51de71e592ec24c4923f2526fe063</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Benefit</topic><topic>Cost</topic><topic>Maintenance therapy</topic><topic>PARP inhibitors</topic><topic>Patient preferences</topic><topic>Risk</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Havrilesky, Laura J.</creatorcontrib><creatorcontrib>Lim, Stephanie</creatorcontrib><creatorcontrib>Ehrisman, Jessie A.</creatorcontrib><creatorcontrib>Lorenzo, Amelia</creatorcontrib><creatorcontrib>Alvarez Secord, Angeles</creatorcontrib><creatorcontrib>Yang, Jui-Chen</creatorcontrib><creatorcontrib>Johnson, F. Reed</creatorcontrib><creatorcontrib>Gonzalez, Juan Marcos</creatorcontrib><creatorcontrib>Reed, Shelby D.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Gynecologic oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Havrilesky, Laura J.</au><au>Lim, Stephanie</au><au>Ehrisman, Jessie A.</au><au>Lorenzo, Amelia</au><au>Alvarez Secord, Angeles</au><au>Yang, Jui-Chen</au><au>Johnson, F. Reed</au><au>Gonzalez, Juan Marcos</au><au>Reed, Shelby D.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Patient preferences for maintenance PARP inhibitor therapy in ovarian cancer treatment</atitle><jtitle>Gynecologic oncology</jtitle><addtitle>Gynecol Oncol</addtitle><date>2020-03</date><risdate>2020</risdate><volume>156</volume><issue>3</issue><spage>561</spage><epage>567</epage><pages>561-567</pages><issn>0090-8258</issn><eissn>1095-6859</eissn><abstract>To measure preferences of women with ovarian cancer regarding risks, side effects, costs and benefits afforded by maintenance therapy (MT) with a poly ADP ribose polymerase (PARP) inhibitor.
A discrete-choice experiment elicited preferences of women with ovarian cancer regarding 6 attributes (levels in parentheses) relevant to decisions for MT versus treatment break: (1) overall survival (OS; 36, 38, 42 months); (2) progression-free survival (PFS; 15, 17, 21 months); (3) nausea (none, mild, moderate); (4) fatigue (none, mild, moderate); (5) probability of death from myelodysplastic syndrome/acute myelogenous leukemia (MDS/AML; 0% to 10%); (6) monthly out-of-pocket cost ($0 to $1000). Participants chose between 2 variable MT scenarios and a static scenario representing treatment break, with multiple iterations. Random-parameters logit regression was applied to model choices as a function of attribute levels.
95 eligible participants completed the survey; mean age was 62, 48% had recurrence, and 17% were ever-PARP inhibitor users. Participants valued OS (average importance weight 24.5 out of 100) and monthly costs (24.6) most highly, followed by risk of death from MDS/AML (17.9), nausea (14.7), PFS (10.5) and fatigue (7.8). Participants would accept 5% risk of MDS/AML if treatment provided 2.2 months additional OS or 4.8 months PFS. Participants would require gains of 2.6 months PFS to accept mild treatment-related fatigue and 4.4 months to accept mild nausea.
When considering MT, women with ovarian cancer are most motivated by gains in OS. Women expect at least 3–4 months of PFS benefit to bear mild side effects of treatment.
•A survey was conducted to elicit the preferences of women with ovarian cancer for risks and benefits of PARP inhibitors.•Overall survival benefit and anticipated out of pocket costs most highly influenced women's choices.•Women expected at least 3–4 months of PFS in exchange for minimal side effects from taking a PARP inhibitor.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>31982178</pmid><doi>10.1016/j.ygyno.2020.01.026</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-4259-5992</orcidid></addata></record> |
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| subjects | Benefit Cost Maintenance therapy PARP inhibitors Patient preferences Risk |
| title | Patient preferences for maintenance PARP inhibitor therapy in ovarian cancer treatment |
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