Daily Management Review

Study Finds Treatment Efficacy Could Be Sacrificed For Reduced Side Effects In Cancer Therapies By Patients


Study Finds Treatment Efficacy Could Be Sacrificed For Reduced Side Effects In Cancer Therapies By Patients
A recent study showed the patients are willing to trade some drug effectiveness for a reduced risk of serious adversative events while they choose their preferred treatment. This is applicable for patients suffering from chronic lymphocytic leukemia (CLL) and the study says that they place the greatest value on drugs that provide the longest progression-free survival.

The study was published online in Blood Advances which is a journal of the American Society of Hematology (ASH). 

The treatment that a patient would choose is also significantly influenced by their factoring of out-of-pocket costs while they re deciding on the choices available to them., the study also suggested.
In the United States, there are more than 20,000 new cases of CLL – the most prevalent form of leukemia, are diagnosed each year and total of about 130,000 people are affected by it in the U.S. And there are many factors that patients have to take into account these days while making a decision about the treatment plan because of the emergence of more treatment methods that are getting approval in recent years and where each one of them has its own related benefits and side effects as well as costs for the patient.

For the study, a survey of 384 people with CLL was conducted by lead study author Carol Mansfield of RTI Health Solutions in collaboration with the Leukemia & Lymphoma Society, the Lymphoma Research Foundation, and Genentech for gaining an insight into the manner in which patients with CLL balance these differences. There were five variable attributes that were attached to each of five chosen hypothetical treatment options which were presented as choices before patients. The attributes included the chance of organ damage, the potential for serious infection, typical severity of diarrhea, the method of administration and progression-free survival.

"While every patient wants the most effective drug with the fewest side effects, most people don't have that option available," said Dr. Mansfield. "By asking patients to make tradeoffs and rank their preference, we can form an understanding of how patients approach their treatment."

For the patients participating in the survey, the most important factor was the effectiveness of the drug, the study found. Also highly valued was avoiding serious adverse events. patients were willing to accept a 30 percent risk of serious infection if there was a gain in 36 months of progression-free survival for the patients on the average. Only a few months of efficacy was what the participating patients were willing to trade for in exchange for a more convenient dosing method such as oral administration.

"This research brings home the point that each patient has unique circumstances and choosing the right treatment means weighing the different efficacy profiles and side effects against the patient's priorities," said Dr. Mansfield. "A successful outcome can be different from one individual to the next, and the outcome they desire depends on their circumstances."

"We used the results from the discrete-choice experiment to forecast the probability that a respondent would pick each hypothetical drug without any mention of cost and then compared that to the choices people made when out-of-pocket costs for these medicines were included," said Dr. Mansfield.  "Cost is clearly something that has an impact. When patients get prescribed something they can't afford, they have to make very difficult choices."


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