Patient and Physician Treatment Preferences in Relapsed/Refractory Follicular Lymphoma: A Discrete Choice Experiment in the United States, United Kingdom, France, Germany, Brazil, and Japan

John Gribben^1*Emmanuel BACHY²Markqayne Ray³Kathryn Krupsky⁴Kathleen Beusterien⁴Lewis Kopenhafer⁴Sara Beygi³Timothy Best³Graeme Ball³Oliver Will⁴Madhu Palivela^3*Anik Patel³Paola Ghione⁵

• ¹Barts Cancer Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, England, United Kingdom
• ²Hospices Civils de Lyon, Lyon, Rhône-Alpes, France
• ³Kite, a Gilead Company, Santa Monica, United States
• ⁴Oracle Life Sciences, Oracle (United States), Austin, Minnesota, United States
• ⁵Memorial Sloan Kettering Cancer Center, New York, New York, United States

The objectives of this study were to identify key treatment attributes that drive physician and patient preferences for second-line (2L) and third-line (3L) treatments in relapsed/refractory (R/R) follicular lymphoma (FL). A multi-country, internet-based survey was administered to patients (N=195) with R/R FL and treating physicians (N=300) from the United States, United Kingdom, France, Germany, Brazil, and Japan. The survey included two discrete choice experiments -one for 2L and one for 3L treatment options -that prompted respondents to select their preferred option between two hypothetical treatment profiles varying on seven attributes associated with treatment for R/R FL: progression-free survival (PFS), overall survival (OS), serious adverse events (AE), cytokine release syndrome (CRS) events, neurological events, fatigue, and administration. Mean preference weights and relative attribute importance were estimated in each sample, overall and by country, using hierarchical Bayesian models. Physician estimates were also stratified by practice setting. Treatment preferences for physicians and patients were most influenced by PFS. Beyond PFS, patients placed greater emphasis on the administration of medications, whereas physicians tended to focus more on five-year OS and toxicity profiles of agents. Preference for PFS above all other 2L and 3L treatment attributes was consistent for physicians, regardless of practice setting and country. However, patient treatment preferences varied by country. These results offer key perspectives on how physicians and patients evaluate treatment options in 2L and 3L treatment settings; this information is essential for facilitating shared decision-making in an expanding, complex treatment landscape.