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探索复发/难治性多发性骨髓瘤治疗中患者最看重的因素:一项针对患者、照护者与医生的加拿大离散选择实验

英文原题:Exploring what matters most to patients in relapsed refractory multiple myeloma treatment: a Canadian discrete choice experiment with patients, caregivers and physicians.

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Exploring what matters most to patients in relapsed refractory multiple myeloma treatment: a Canadian discrete choice experiment with patients, caregivers and physicians.

PubMed 2025/07/01(内容时间) BMC Cancer Q2 · IF 4.1(JCR 2025)

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研究概要

虽然参与者在 CAR-T 疗法与传统治疗的管理方案之间没有表现出显著偏好,但 CAR-T 疗法因其可能提高生存率和降低长期副作用风险的临床获益而受到青睐。这些发现对加拿大以患者为中心的临床和报销决策具有重要价值,凸显了 CAR-T 疗法在满足患者需求方面的潜在作用。

研究思路结论见上方概要

复发/难治性多发性骨髓瘤(RRMM)显著影响患者的生活质量。本研究调查了加拿大RRMM患者对治疗特征的偏好,比较了传统治疗与嵌合抗原受体(CAR)T细胞疗法的属性。研究旨在了解患者偏好,以及照护者和医疗保健专业人员(HCP)如何看待这些偏好。

开展了一项离散选择实验(DCE),纳入101例RRMM患者、46名照护者和49名HCP。探讨了五个属性:PFS、10年生存机会、严重副作用风险、长期中度副作用风险和治疗给药方式。参与者被要求在12个问题的一系列问题中,在两种假设治疗之间进行选择。假设治疗包括CAR-T 给药治疗和通过常规方式给药的替代治疗(“常规治疗”),其余属性表现水平各不相同。

延长的PFS和10年生存机会是所有群体治疗决策中最关键的因素。长期中度副作用比严重的短期副作用更令人担忧,而治疗给药方式最不重要。患者愿意为了改善生存而接受更高的副作用风险。患者偏好与照护者及HCP对这些偏好的认知之间高度一致。

展开英文摘要原文

Relapsed/refractory multiple myeloma (RRMM) significantly impacts patients' quality of life. This study investigated treatment characteristic preferences for RRMM in Canada, comparing attributes of conventional treatments to those of Chimeric antigen receptor (CAR) T-cell therapy. It aimed to understand patient preferences and how caregivers and healthcare professionals (HCPs) perceive these preferences.

A discrete choice experiment (DCE) was conducted with 101 RRMM patients, 46 caregivers, and 49 HCPs. Five attributes were explored: progression-free survival (PFS), 10-year survival chance, risk of serious side effects, risk of long-term moderate side effects, and treatment administration. Participants were asked to choose between two hypothetical treatments in a series of 12 questions. Hypothetical treatments included CAR-T-administered treatments and alternative treatments administered by conventional means ("conventional treatments") with varying levels of performance across remaining attributes.

Prolonged PFS and 10-year survival chance were the most critical factors in treatment decisions across all groups. Long-term moderate side effects were more concerning than serious short-term side effects, while treatment administration was least important. Patients were willing to accept higher side effect risks for improved survival. High agreement was found between patients' preferences and caregivers' and HCPs' perceptions of these preferences.

While participants showed no significant preference between the administration profiles of CAR-T therapy and conventional treatments, CAR-T therapy was favored for its clinical benefits of potentially increased survival and lower long-term side effect risks. These findings are valuable for Canadian patient-centered clinical and reimbursement decision-making, highlighting the potential role of CAR-T therapy in addressing patient needs.

论文信息

作者
Hall R、Chua GN、Macfarlane B、Plante RK、Shi K、Soltys S、McCurdy A、Elias M
单位
Acaster Lloyd Consulting Ltd, London, UK. rebekah.hall@acasterlloyd.com.United Kingdom
期刊
BMC cancer2025 Jul 1
原文标识
PubMed 40597849 · DOI 10.1186/s12885-025-14490-5