Patient preferences for adjuvant interferon alfa-2b treatment

Area of Science:

• Oncology
• Health Economics
• Patient-Reported Outcomes

Background:

• Adjuvant interferon alfa-2b (IFN alpha-2b) shows potential for improving disease-free survival in high-risk melanoma.
• Significant toxicity of IFN alpha-2b limits its widespread use.
• Quantifying patient preferences for survival benefits versus treatment toxicity is crucial.

Purpose of the Study:

• To assess patient utilities for health states associated with adjuvant IFN alpha-2b therapy.
• To quantify the trade-offs between IFN alpha-2b toxicity and survival benefits.
• To inform clinical trial quality-of-life determinations for adjuvant IFN alpha-2b.

Main Methods:

• Utilities for health states were assessed in 107 low-risk melanoma patients using the standard gamble technique.
• Health states included IFN alpha-2b toxicity scenarios and posttreatment outcomes (disease-free health, recurrence, cancer death).
• Patients indicated required improvement in 5-year disease-free survival to tolerate IFN toxicity.

Main Results:

• Patient utilities for melanoma recurrence were significantly lower than for any IFN alpha-2b toxicity.
• Half of patients would tolerate mild-moderate toxicity for a 4% improvement in 5-year disease-free survival.
• Half of patients would tolerate severe toxicity for a 10% improvement in 5-year disease-free survival.

Conclusions:

• Melanoma recurrence is rated by patients as having a much lower quality of life than severe IFN alpha-2b toxicity.
• Recurrence-free survival is highly valued by patients.
• Measured utilities can be used in clinical trials to determine the net benefit of adjuvant IFN alpha-2b therapy.