Original Research ARTICLE
Patient preferences regarding chemotherapy in metastatic breast cancer – a conjoint analysis for common taxanes
- 1Klinik für Frauenheilkunde und Geburtshilfe, Universitätsmedizin Mannheim, Medizinische Fakultät Mannheim, Universität Heidelberg, Germany
- 2Abteilung für Medizinische Statistik, Biomathematik und Informationsverarbeitung, Medizinische Fakultät Mannheim, Universität Heidelberg, Germany
- 3Private Oncology Center Fuxius/Karcher, Heidelberg, Germany, Germany
- 4Theresienkrankenhaus und St. Hedwig-Klinik GmbH Abteilung für Gynäkologie und Geburtshilfe, Germany
Background: Purpose of this investigation was to explore patient perception regarding the importance of efficacy, toxicity and regimen of taxane-based chemotherapy (CHT) for metastatic breast cancer (MBC).
Methods: This dual-center study analysed data of 100 women diagnosed with MBC, who were asked for their preferences regarding chemotherapy by means of conjoint analysis. Included attributes were progression free survival (PFS), application form, time and frequency, need of premedication, risk of alopecia, fatigue, febrile neutropenia and neuropathy. Furthermore, participants completed a questionnaire about their personal and medical history. Regression analyses were performed to identify factors that influence patient preference in terms of specific treatment choice.
Results: Of 8 attributes, severe neutropenia was top priority for the majority of patients, followed by alopecia, neuropathy and PFS. When combining these patient preferences and the results of the questionnaire, patients´ age as well as relationship status had significant impact on the importance of PFS. Moreover, longer travel time to the treatment centre was significantly associated with preferences regarding PFS. Ranking by combination of respective part-worth values demonstrated nab-paclitaxel to be favoured over paclitaxel and docetaxel.
Conclusion: Side effects of CHT and PFS prove to be critical factors for patients affecting choice of treatment in MBC with severe neutropenia being top priority, followed by alopecia, neuropathy and PFS. Age, commute time and relationship status were identified as significant determinants of patient preference. Total utility calculation by combination of part-worth values ranked nab-paclitaxel as the most preferable taxane.
Keywords: metastatic breast cancer, Patient Preference, shared decision-making, chemotherapy, Conjoint Analysis, Taxane
Received: 03 Aug 2018;
Accepted: 31 Oct 2018.
Edited by:José Bines, Instituto Nacional de Câncer (INCA), Brazil
Reviewed by:Connie I. Diakos, Kolling Institute, Australia
Tarah Ballinger, Indiana University – Purdue University Indianapolis, United States
Copyright: © 2018 Spaich, Kinder, Hetjens, Fuxius, Gerhardt and Sütterlin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Dr. Saskia Spaich, Klinik für Frauenheilkunde und Geburtshilfe, Universitätsmedizin Mannheim, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany, email@example.com