TY - JOUR
T1 - High-dose chemotherapy for patients with stage III breast cancer with homologous recombination deficiency
T2 - a discrete choice experiment among healthcare providers
AU - Verbeek, Joost G.E.
AU - Azarang, Leyla
AU - Pilli, Luis E.
AU - De Jong, Vincent M.T.
AU - Jager, Agnes
AU - Linn, Sabine C.
AU - Retèl, Valesca P.
AU - Van Harten, Wim H.
PY - 2024/9/10
Y1 - 2024/9/10
N2 - 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.
AB - 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.
KW - Breast neoplasms
KW - homologousrecombination
KW - BRCA1protein
KW - BRCA2 protein
KW - discrete choice experiment
KW - conjoint analysis
KW - implementation science
UR - http://www.scopus.com/inward/record.url?scp=85204099135&partnerID=8YFLogxK
U2 - 10.2340/1651-226X.2024.40276
DO - 10.2340/1651-226X.2024.40276
M3 - Article
C2 - 39256991
AN - SCOPUS:85204099135
VL - 63
SP - 701
EP - 709
JO - Acta oncologica (Stockholm, Sweden)
JF - Acta oncologica (Stockholm, Sweden)
IS - 1
ER -