Patient Preferences on Clinical Decision Making in Multiple Myeloma.

Area of Science:

• Oncology
• Hematology
• Patient-reported outcomes

Background:

• Multiple myeloma treatment aims to prolong survival and improve quality of life.
• Understanding patient priorities is crucial for shared decision-making in treatment selection.

Purpose of the Study:

• To investigate patient preferences regarding multiple myeloma treatments with varying progression-free survival (PFS) and overall survival (OS) benefits.
• To identify patient priorities when faced with treatment choices involving trade-offs in efficacy and toxicity.

Main Methods:

• A survey was administered to patients with multiple myeloma and related plasma cell dyscrasias via the HealthTree Cure Hub.
• Patients evaluated four distinct treatment scenarios with differing PFS, OS, and toxicity profiles.

Main Results:

• 56% of patients preferred a four-drug regimen over a three-drug regimen for frontline treatment, despite similar OS and increased toxicity.
• 50% chose consolidation treatment that improved PFS but not OS.
• Only 17% opted for two-drug maintenance therapy over one-drug therapy for better PFS, and 7% accepted a treatment for relapsed disease with improved PFS but no OS benefit and increased toxicity.

Conclusions:

• Patient decisions are heavily influenced by the impact of treatment on overall survival (OS) and the presence of substantial clinical, financial, or time toxicities.
• Many patients prioritize OS and toxicity over PFS improvements when these do not translate to better long-term survival outcomes.