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Patient preferences for maintenance PARP therapy in ovarian cancer treatment.

Publication ,  Conference
Havrilesky, LJ; Lim, S; Yang, J-C; Lorenzo, A; Ehrisman, JA; Secord, AA; Johnson, R; Reed, SD
Published in: Journal of Clinical Oncology
May 20, 2019

5558 Background: Maintenance therapy with PARP inhibitors has become prevalent in treating ovarian cancer. However, the preferences of women with ovarian cancer regarding the risks, side effects and benefits afforded by maintenance therapies are largely unstudied. Methods: A discrete choice experiment was designed to elicit the preferences of women with ovarian cancer regarding 6 attributes (levels presented in parentheses) relevant to the decision for maintenance PARP inhibitor therapy versus surveillance: (1) overall survival (36, 38, 42 months); (2) progression-free survival (15, 17, 21 months); (3) nausea (none, mild, moderate); (4) fatigue (none, mild, moderate); (5) probability of death from myelodysplastic syndrome/acute myelogenous leukemia (MDS/AML) (0%, 1%, 5%, 10%); and (6) monthly out-of-pocket cost ($0, $50, $500, $1,000). Educational material was provided, with embedded questions to test respondents’ understanding. Participants chose between 2 variable clinical scenarios and a constant scenario representing a treatment break, with multiple iterations. Random-parameters logit regression was applied to model participants’ choices as a function of attribute levels. Results: Of 150 women with ovarian cancer recruited, 95 were eligible and completed the survey. The mean age was 62, 48% had recurrent ovarian cancer, and 13% were currently taking a PARP. Participants always significantly preferred better clinical outcomes to worse (except between 0% and 1% risk of MDS/AML), preferred low out-of-pocket cost, and disliked the idea of a treatment break. Participants valued overall survival most (average importance weight 25 out of 100 total), followed by monthly out-of-pocket cost (24), risk of death from MDS/AML (18), nausea (15), PFS (10) and fatigue (8). On average, participants would tolerate a 2% additional risk of MDS/AML in exchange for 2 additional months of PFS and 7% additional risk of MDS/AML in exchange for 6 additional months of PFS. Conclusions: Women with ovarian cancer are willing to accept the side effects of PARP maintenance therapy and a higher than clinically observed risk of MDS/AML in exchange for clinically observed levels of improvement in PFS.

Duke Scholars

Published In

Journal of Clinical Oncology

DOI

EISSN

1527-7755

ISSN

0732-183X

Publication Date

May 20, 2019

Volume

37

Issue

15_suppl

Start / End Page

5558 / 5558

Publisher

American Society of Clinical Oncology (ASCO)

Related Subject Headings

  • Oncology & Carcinogenesis
  • 3211 Oncology and carcinogenesis
  • 1112 Oncology and Carcinogenesis
  • 1103 Clinical Sciences
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Havrilesky, L. J., Lim, S., Yang, J.-C., Lorenzo, A., Ehrisman, J. A., Secord, A. A., … Reed, S. D. (2019). Patient preferences for maintenance PARP therapy in ovarian cancer treatment. In Journal of Clinical Oncology (Vol. 37, pp. 5558–5558). American Society of Clinical Oncology (ASCO). https://doi.org/10.1200/jco.2019.37.15_suppl.5558
Havrilesky, Laura Jean, Stephanie Lim, Jui-Chen Yang, Amelia Lorenzo, Jessie A. Ehrisman, Angeles Alvarez Secord, Reed Johnson, and Shelby D. Reed. “Patient preferences for maintenance PARP therapy in ovarian cancer treatment.” In Journal of Clinical Oncology, 37:5558–5558. American Society of Clinical Oncology (ASCO), 2019. https://doi.org/10.1200/jco.2019.37.15_suppl.5558.
Havrilesky LJ, Lim S, Yang J-C, Lorenzo A, Ehrisman JA, Secord AA, et al. Patient preferences for maintenance PARP therapy in ovarian cancer treatment. In: Journal of Clinical Oncology. American Society of Clinical Oncology (ASCO); 2019. p. 5558–5558.
Havrilesky, Laura Jean, et al. “Patient preferences for maintenance PARP therapy in ovarian cancer treatment.Journal of Clinical Oncology, vol. 37, no. 15_suppl, American Society of Clinical Oncology (ASCO), 2019, pp. 5558–5558. Crossref, doi:10.1200/jco.2019.37.15_suppl.5558.
Havrilesky LJ, Lim S, Yang J-C, Lorenzo A, Ehrisman JA, Secord AA, Johnson R, Reed SD. Patient preferences for maintenance PARP therapy in ovarian cancer treatment. Journal of Clinical Oncology. American Society of Clinical Oncology (ASCO); 2019. p. 5558–5558.

Published In

Journal of Clinical Oncology

DOI

EISSN

1527-7755

ISSN

0732-183X

Publication Date

May 20, 2019

Volume

37

Issue

15_suppl

Start / End Page

5558 / 5558

Publisher

American Society of Clinical Oncology (ASCO)

Related Subject Headings

  • Oncology & Carcinogenesis
  • 3211 Oncology and carcinogenesis
  • 1112 Oncology and Carcinogenesis
  • 1103 Clinical Sciences