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Increased survival time or better quality of life? Trade-off between benefits and adverse events in the systemic treatment of cancer

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Abstract

Introduction

Primary objective of the study was to assess the relative weighting between benefit in survival time (SV), benefit in quality of life (QoL) and willingness to experience adverse events (AEs), in patient preferences for chemotherapy treatment.

Materials and methods

We included cancer patients with current or past systemic treatment of cancer (STC) as well as physicians placed as hypothetical patients. Participants filled a choice-based conjoint analysis questionnaire with 19 choices among three STC scenarios with variable amounts of benefit in SV or QoL and different types AEs.

Results

One hundred patients (50 on curative and 50 on palliative intention treatment) and 114 physicians (61 oncologists and 53 non-oncologists) were included and asked about their preferred chemotherapy treatment. The relative weighting (sum 100%) of SV–QoL–AEs for making the choice in the 100 patients was SV35%–CV33%–AEs31% what was not significantly different from a random distribution (Goodness of fit Chi square P = 0.91) just as it was not for both subgroups, palliative (SV37%–QoL29%–AEs34%; GoF Chi square P = 0.55) and curative (SV34%–QoL36%–AEs30%; GoF Chi square P = 0.73) treatment. The observed distribution in the group of 114 physicians (SV46%–QoL31%–AEs23%) was significantly different from a random distribution (GoF Chi square P = 0.018) just as it was for both subgroups, medical oncologists (SV48%-QoL29%-AEs23%; GoF Chi square P = 0.006) and non-medical oncologists (SV44%–QoL33%–AEs23%; GoF Chi square P = 0.04).

Conclusions

The three attributes (SV, QoL, and AEs) are considered in the same way by cancer patients to make choices on their STC. On the contrary, when placed as hypothetical patients, physicians prefer for themselves those treatments that provide more SV.

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Funding

“Associació Oncológica Dr Amadeu Pelegrí” (www.aodapelegri.com), which is a charitable association leaded by cancer patients based in Salou (Spain).

Author information

Authors and Affiliations

  1. Medical Oncology Department Hospital Santa Tecla, Hospital de Sant Pau i Santa Tecla, Tarragona, C/Rambla Vella 14, 43003, Tarragona, Spain

    V. Valentí

  2. Hospital de Sant Pau i Santa Tecla, Tarragona, Tarragona, Spain

    J. Ramos, L. Capdevila, L. Tikhomirova & E. Sopena

  3. Hospital del Vendrell. El Vendrell, Tarragona, Tarragona, Spain

    C. Pérez & I. Ruiz

  4. Psyma Ibérica Marketing Research SL, Madrid, Spain

    M. Sánchez

  5. Hospital de Fuenlabarada, Fuenlabarada, Madrid, Spain

    I. Juez

  6. Hospital Verge de la Cinta, Tortosa, Tarragona, Spain

    M. Llobera

  7. Institut Català d’Oncologia (ICO), Girona, Girona, Spain

    J. Rubió

  8. Institut Català d’Oncologia (ICO), L’Hospitalet de Llobregat, Barcelona, Spain

    R. Salazar

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  1. V. Valentí
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  2. J. Ramos
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  3. C. Pérez
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  4. L. Capdevila
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  5. I. Ruiz
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  6. L. Tikhomirova
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  7. M. Sánchez
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  8. I. Juez
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  9. M. Llobera
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  10. E. Sopena
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  11. J. Rubió
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  12. R. Salazar
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Corresponding author

Correspondence to V. Valentí.

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Conflict of interest

The authors declare that they have no conflict of interest regarding the publication of this article.

Ethical approval

The study was approved by the Institutional Review Board of the participant centers.

Informed consent

All the patients signed written informed consent before their inclusion in the study.

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Valentí, V., Ramos, J., Pérez, C. et al. Increased survival time or better quality of life? Trade-off between benefits and adverse events in the systemic treatment of cancer. Clin Transl Oncol 22, 935–942 (2020). https://doi.org/10.1007/s12094-019-02216-6

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  • DOI: https://doi.org/10.1007/s12094-019-02216-6

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