Treatment preferences among Japanese patients and physicians for epidermal growth factor receptor-mutant non-small
Akito Hata1, Simon Fifer2, Kazuo Hasegawa3
1Division of Thoracic Oncology, Kobe Minimally Invasive Cancer Center, Kobe, Hyogo, Japan.
Introduction:
Evidence is limited on preferences of Japanese patients and physicians in treatment for epidermal growth factor receptor (EGFR)-mutant non-small cell lung cancer (NSCLC). Several oral or intravenous novel agents for EGFR exon 20 insertions are under development. The aim of our study was to investigate which attributes of novel treatments influenced selection of oral or intravenous agents among treated patients and treating physicians in Japan.
Methods:
The study was designed by board-certified oncologists, patient representatives, and analytics specialists. Eligible participants completed an online survey with a discrete choice experiment presenting two treatment profiles described by attributes: mode of administration (oral or intravenous); frequency of administration; overall response rate (ORR); average progression-free survival (PFS); chance of experiencing severe side effects (SEs); mild-moderate gastrointestinal SEs; mild-moderate skin-related SEs; and patient out-of-pocket costs.
Results:
Fifty-four patients (all self-reported EGFR-mutant) and 74 physicians participated from December 2021 to August 2022. All attributes being equal, there was greater preference for oral administration. However, there was greater preference for intravenous over oral, when ORR and PFS improved by 10% and 1 month, and severe SEs reduced by 10%. Physicians exhibited greater preference for PFS compared to patients (p < 0.01). Ranked order of attribute importance was as follows: (1) PFS; (2) ORR; (3) severe SEs, expressed by patients and physicians alike.
Conclusions:
Our study revealed Japanese physician and patient preferences in treatment options for EGFR-mutant NSCLC. Compared to the strong preference for a more efficacious drug, the preference of oral versus intravenous revealed a smaller impact.
Insights
Japanese patients and physicians prioritize drug efficacy (progression-free survival, overall response rate) over administration route for EGFR-mutant non-small cell lung cancer treatments.
Area of Science:
- Oncology
- Pharmacology
- Patient-centered care
Background:
- Limited data exists on Japanese patient and physician preferences for treating epidermal growth factor receptor (EGFR)-mutant non-small cell lung cancer (NSCLC).
- Novel oral and intravenous agents for EGFR exon 20 insertions are in development, necessitating preference evaluation.
Purpose of the Study:
- To investigate patient and physician preferences for novel treatments in EGFR-mutant NSCLC in Japan.
- To determine the influence of administration route (oral vs. intravenous) and other attributes on treatment selection.
Main Methods:
- A discrete choice experiment was conducted via online surveys with 54 EGFR-mutant NSCLC patients and 74 physicians in Japan.
- Treatment profiles were described by administration route, frequency, overall response rate (ORR), progression-free survival (PFS), severe side effects (SEs), and out-of-pocket costs.
Main Results:
- A preference for oral administration existed when all other attributes were equal.
- Intravenous administration was preferred when associated with improved ORR (+10%), PFS (+1 month), and reduced severe SEs (-10%).
- Physicians showed a greater preference for PFS than patients (p < 0.01). Attribute importance ranked: PFS > ORR > severe SEs.
Conclusions:
- Efficacy attributes (PFS, ORR) and severe side effects significantly influenced treatment preferences for EGFR-mutant NSCLC in Japan.
- The impact of administration route (oral vs. intravenous) was less influential compared to efficacy.
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