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Assessment of Metastatic Colorectal Cancer Patients’ Preferences for Biologic Treatments in Germany Using a Discrete Choice Experiment

Published:December 20, 2021DOI:https://doi.org/10.1016/j.clcc.2021.12.002

      Highlights

      • Treatment preference analysis in German metastatic colorectal cancer patients.
      • Main driver for treatment decision was efficacy, followed by safety and frequency.
      • Overall survival was the main driver for treatment choice in all subgroups.
      • Risk of severe skin toxicities was more important in women than men.
      • Risk of side effects more important to those with prior experience of side effects.

      Abstract

      Background

      Current treatment regimens for metastatic colorectal cancer (mCRC) include biologics such as epidermal growth factor receptor and vascular endothelial growth factor inhibitors, which have specific side-effect profiles. There is a lack of information on mCRC patient preference in Germany regarding biologics in combination with chemotherapy. This study aims to identify German mCRC patients’ preference for these treatments

      Patients and Methods

      This was a multicenter cross-sectional discrete choice experiment (DCE). Data were collected using electronic case report forms and structured phone interviews. DCE attributes were related to efficacy, side effects, frequency of administration, and distance to treating physicians’ practice. Patients’ characteristics and choices were analyzed descriptively. Choice data was modeled using a random utility maximization framework.

      Results

      All attributes, except distance to treating physicians’ practice, had a significant impact on patients’ decision. The most important driver of patients’ treatment decision was overall survival, followed by safety-related attributes and frequency of administration. Overall survival was the main driver in all subgroups analyzed. Risk of severe skin toxicities was more important to women, than men. In patients with prior experience of side effects, the risk of side effects accounted for 45% of a patient's decision, compared to 35% in those without prior experience.

      Conclusion

      Overall survival remains the most important driver in mCRC patients’ preferences for biologic treatment in combination with chemotherapy. Attributes related to safety were less important to patients when considering their treatment decision. These results indicate that understanding patient preferences may lead to increased treatment compliance.

      Keywords

      Abbreviations:

      AEs (adverse events), CRC (colorectal cancer), DCE (discrete choice experiment), ECOG (Eastern Cooperative Oncology Group), EGFR (epidermal growth factor receptor), GI (gastrointestinal), mCRC (metastatic colorectal cancer), ORR (overall response rate), OS (overall survival), PFS (progression-free survival), RAS (Rat sarcoma), SD (standard deviation), SmPC (summary of product characteristics), VEGF (vascular endothelial growth factor), WT (wild-type)
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