Patients' Preferences for Adjuvant Osimertinib in Non-Small-Cell Lung Cancer After Complete Surgical Resection: What Makes It Worth It to Patients?

Autor: Awidi M; Roswell Park Comprehensive Cancer Center, Buffalo, NY. Electronic address: Muhammad.awidi@roswellpark.org., Mier-Hicks A; Texas Oncology, Dallas, TX., Perimbeti S; Roswell Park Comprehensive Cancer Center, Buffalo, NY., Attwood K; Roswell Park Comprehensive Cancer Center, Buffalo, NY., Chen H; Roswell Park Comprehensive Cancer Center, Buffalo, NY., Jain P; Roswell Park Comprehensive Cancer Center, Buffalo, NY., Yau E; Roswell Park Comprehensive Cancer Center, Buffalo, NY., Early A; Roswell Park Comprehensive Cancer Center, Buffalo, NY., Dy GK; Roswell Park Comprehensive Cancer Center, Buffalo, NY.
Jazyk: angličtina
Zdroj: Clinical lung cancer [Clin Lung Cancer] 2024 Sep; Vol. 25 (6), pp. 509-518. Date of Electronic Publication: 2024 May 29.
DOI: 10.1016/j.cllc.2024.05.003
Abstrakt: Background: The ADAURA trial confirmed adjuvant Osimertinib's efficacy in EGFR-mutated Non-small-cell lung cancer (NSCLC), yet the limited mature overall survival (OS) data at approval poses a challenge. This study explores patient preferences in the absence of complete OS information, hypothesizing that disease-free survival (DFS) benefit alone may influence adjuvant Osimertinib pursuit.
Methods: At Roswell Park Comprehensive Cancer Center (Jan-Dec 2021), patients assessed for adjuvant therapy received a survey probing OS and DFS preferences. Scenarios were (a) minimum OS justifying Osimertinib, (b) minimum DFS improvement justifying 3-years of adjuvant Osimertinib, (c) minimum 5-year DFS percent change, and (d) minimum OS justifying copay changes. Results were analyzed.
Results: Of 524 NSCLC patients, 51 participated. Scenario 1 saw 56% requiring a 12-month OS benefit for Osimertinib justification. In scenario 2, 72% deemed a 12-month DFS benefit sufficient. Scenario 3 revealed 31% opting out despite a 10% OS increase. Scenario 4 showed varied willingness to pay, with 33% unwilling to any shoulder copayment even with a 10-year OS benefit.
Conclusion: This study explores patient preferences without complete OS data, revealing diverse thresholds. Factors include employment, education, and willingness to pay. Findings underscore shared decision-making importance. Limitations include sample size, potential biases, and regional focus; larger cohorts are needed for validation.
Competing Interests: Disclosure The authors have stated that they have no conflicts of interest.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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