Abstract
BackgroundThis study aimed to identify factors affecting patients’ preferences for postmenopausal hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2−) advanced breast cancer treatments, their relative importance, and impact of sociodemographic/clinical characteristics.MethodsJapanese postmenopausal patients with HR+ breast cancer chose between 2 hypothetical treatments for HR+/HER2− advanced breast cancer using an online discrete choice experiment, defined by different levels of 5 attributes: progression-free survival (PFS), incidence of diarrhea (IOD), frequency of loose stools of grade 1–3 severity (FOS), duration of diarrhea (DOD), and route/frequency of administration (RFA). Conditional logit modeling identified relative preferences for each attribute. Subgroup analyses, based on sociodemographic characteristics (age, employment status, age of youngest child, marital status) and clinical characteristics (relapse/metastasis, hormone sensitivity), identified factors affecting preferences.ResultsOf 896 participants screened, 258 eligible participants were included in analyses. Patient preferences, when the potential frequency of diarrhea was grade 2, were (strongest to weakest): PFS, DOD, FOS, IOD, RFA; however, when the potential frequency of diarrhea was grade 3, FOS became most important. Sociodemographic/clinical characteristics tended to affect preferences.ConclusionsJapanese postmenopausal patients with HR+ breast cancer preferred treatments that extend PFS despite potential grade 2 diarrhea. However, when diarrhea severity increased to grade 3, patients were more willing to sacrifice PFS to avoid more frequent diarrhea. Prevention or limitation of diarrhea to grade ≤ 2 is important for maintaining patients’ motivation for treatment that can extend PFS. Additionally, patient characteristics (age, family context, therapeutic experience) should be considered during treatment choice.
Highlights
GLOBOCAN 2018 estimates that over 2 million individuals globally were affected by breast cancer, making it the second most common cancer worldwide in 2018 [1]
Postmenopausal patients with HR+ breast cancer in Japan had a strong preference for treatment that can extend progression-free survival (PFS) even with the potentiality of grade 2 diarrhea
The results progression-free survival, Responsive HR responsive, Resist primary resistance, acquired resistance, or no experience of HR therapy demonstrated that if the frequency of loose stools increased to grade 3, this attribute became the most important attribute in patients’ treatment preferences
Summary
GLOBOCAN 2018 estimates that over 2 million individuals globally were affected by breast cancer, making it the second most common cancer worldwide in 2018 [1]. Hormone receptor-positive (HR+) breast cancer accounts for approximately 80% of all breast cancer cases [5] and single-agent endocrine therapy is the mainstay for treatment for HR+, human epidermal growth factor receptor. This study aimed to identify factors affecting patients’ preferences for postmenopausal hormone receptorpositive (HR+), human epidermal growth factor receptor 2-negative (HER2−) advanced breast cancer treatments, their relative importance, and impact of sociodemographic/clinical characteristics. Methods Japanese postmenopausal patients with HR+ breast cancer chose between 2 hypothetical treatments for HR+/ HER2− advanced breast cancer using an online discrete choice experiment, defined by different levels of 5 attributes: progression-free survival (PFS), incidence of diarrhea (IOD), frequency of loose stools of grade 1–3 severity (FOS), duration of diarrhea (DOD), and route/frequency of administration (RFA). Conclusions Japanese postmenopausal patients with HR+ breast cancer preferred treatments that extend PFS despite potential grade 2 diarrhea. Patient characteristics (age, family context, therapeutic experience) should be considered during treatment choice
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