High-dose chemotherapy for patients with stage III breast cancer with homologous recombination deficiency: a discrete choice experiment among healthcare providers

Background and purpose: High-dose chemotherapy with autologous stem cell rescue (HDCT) is currently under investigation as a potential therapy for patients with stage III HER2-negative breast cancer with homologous recombination deficiency (HRD). In addition to survival, the impact on short- and lon...

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Veröffentlicht in:Acta oncologica Jg. 63; H. 1; S. 701 - 709
Hauptverfasser: Verbeek, Joost G.E., Azarang, Leyla, Pilli, Luis E., De Jong, Vincent M.T., Jager, Agnes, Linn, Sabine C., Retèl, Valesca P., Van Harten, Wim H.
Format: Journal Article
Sprache:Englisch
Veröffentlicht: Sweden MJS Publishing on behalf of Acta Oncologica 10.09.2024
Medical Journals Sweden
Schlagworte:
Adult
Aged
Antineoplastic Combined Chemotherapy Protocols - adverse effects
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
BRCA1 Protein
BRCA2 Protein
Breast neoplasms
Breast Neoplasms - drug therapy
Breast Neoplasms - genetics
Breast Neoplasms - pathology
Choice Behavior
Conjoint Analysis
Discrete Choice Experiment
Female
Health Personnel - psychology
Homologous Recombination
Humans
Middle Aged
Neoplasm Staging
Original
Receptor, ErbB-2 - metabolism
ISSN:1651-226X, 0284-186X, 1651-226X
Online-Zugang:Volltext
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Zusammenfassung:Background and purpose: High-dose chemotherapy with autologous stem cell rescue (HDCT) is currently under investigation as a potential therapy for patients with stage III HER2-negative breast cancer with homologous recombination deficiency (HRD). In addition to survival, the impact on short- and long-term side effects might influence the uptake of HDCT by healthcare professionals. As part of the SUBITO trial, we investigated healthcare professionals’ treatment (outcome) preferences for patients with HRD stage III HER2-negative breast cancer and established how healthcare professionals make trade-offs between these treatment outcomes. Patients/material and methods: We conducted a discrete choice experiment in which healthcare professionals were asked to choose repeatedly between scenarios with two treatment options (HDCT or standard of care (SOC)) that varied in outcome with respect to 10-year overall survival (OS), short-term toxicity, long-term cognitive impairment, and premature menopause. We analysed treatment preferences, relative importance, and trade-offs using a multinomial logistic model. Results and interpretation: Thirty-five of the 151 dedicated breast cancer professionals with extensive experience in treating breast cancer patients completed the survey. The 10-year OS and long-term cognitive impairment were the most important attributes. The results indicate a requirement of 10.4% and 25.1% absolute additional improvement in the 10-year survival rate to justify accepting moderate or severe long-term cognitive impairment as a trade-off, respectively. Therefore, we found in our dataset that healthcare professionals expected a large improvement in 10-year OS to accept moderate to severe cognitive impairment. This information calls for further research into chemotherapy-related cognitive impairment, shared decision-making, and treatment preferences for patients with stage III breast cancer.
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Supplemental data for this article can be accessed online at https://doi.org/10.2340/1651-226X.2024.40276
ISSN:1651-226X
0284-186X
1651-226X
DOI:10.2340/1651-226X.2024.40276