Understanding treatment decisions for Hodgkin lymphoma: a qualitative study

Area of Science:

• Oncology
• Health Services Research
• Clinical Decision-Making

Background:

• Hodgkin lymphoma (HL) presents treatment challenges for both young and older patients.
• Multiple initial treatment options exist for newly diagnosed Hodgkin lymphoma.
• Understanding physician decision-making is crucial for optimizing HL care.

Purpose of the Study:

• To explore practicing oncologists' perspectives on treatment decisions for newly diagnosed Hodgkin lymphoma.
• To identify factors influencing initial treatment choices in Hodgkin lymphoma care.

Main Methods:

• Conducted 22 semi-structured interviews with oncologists treating newly diagnosed Hodgkin lymphoma.
• Employed thematic analysis guided by the Anderson Behavioral Model of Health Services framework.
• Grouped findings into contextual factors, individual characteristics, and physician preferences.

Main Results:

• Paternalism and collaboration between community and academic oncologists were frequently reported.
• Sequential therapy was common, but geriatric assessment was not consistently used for older patients.
• Physician views on frontline brentuximab vedotin (Bv)-based therapy varied due to benefit-toxicity perceptions.

Conclusions:

• Physician decision-making in Hodgkin lymphoma is influenced by various factors, including paternalism and collegial collaboration.
• Heterogeneity in clinical practice, particularly regarding new therapies like brentuximab vedotin, requires further investigation.
• There is a need to better understand and address variations in Hodgkin lymphoma treatment approaches, especially in the evolving therapeutic landscape.