Treatment Decision-Making for Individuals with Relapsed/Refractory Chronic Lymphocytic Leukemia in the USA.

INTRODUCTION: As available treatment options for relapsed/refractory (R/R) chronic lymphocytic leukemia (CLL) increase, treatment decisions become increasingly complex. This cross-sectional study evaluated patient and physician decision-making when selecting treatment for R/R CLL in the USA. METHODS: After an initial pilot, 100 individuals with R/R CLL and 100 physicians who treat R/R CLL completed web-based surveys on factors that influenced treatment selection and levels of involvement during treatment selection. Categorical measures were summarized using numbers/proportions, and continuous measures were summarized using means/standard deviations. RESULTS: Individuals with R/R CLL and physicians prioritized treatment efficacy (individuals: N = 47 of 78, 60.3%; physicians: N = 79 of 100, 79.0%) and potential side effects (individuals: N = 43 of 78, 55.1%; physicians: N = 50 of 79, 63.3%) when selecting treatment. Differences in the relative importance of specific factors were observed. Financial and cost factors were important for individuals, while medical history was important for physicians. Both cohorts reported a shared decision-making process. CONCLUSION: Building upon previous findings in the front-line CLL setting, this study confirms that individuals with R/R CLL and physicians commonly consider efficacy and safety of different treatment options when making their decision. Relative importance of specific factors within these and other categories differs across the samples.

Duke Scholars

Author Thomas William LeBlanc Medicine, Hematologic Malignancies and Cellular Therapy