PMID- 36658529 OWN - NLM STAT- MEDLINE DCOM- 20230123 LR - 20230123 IS - 1471-2407 (Electronic) IS - 1471-2407 (Linking) VI - 23 IP - 1 DP - 2023 Jan 19 TI - Risk thresholds for patients to switch between daily tablets and biweekly infusions in second-line treatment for advanced hepatocellular carcinoma: a patient preference study. PG - 66 LID - 10.1186/s12885-022-10388-8 [doi] LID - 66 AB - BACKGROUND: Historically, high hepatocellular carcinoma (HCC)-related mortality has been, in part, due to lack of effective therapies; however, several systemic therapies have been recently approved for HCC treatment, including regorafenib and ramucirumab. These two treatments utilize different routes of administration (four daily tablets and biweekly intravenous infusions, respectively) and have different risks of adverse events (AEs). However, we lack data on patient preferences in balancing the route of administration and risk of AEs in patients with HCC. We aimed to determine patient preferences and trade-offs for second-line treatment in patients with HCC. METHODS: Patients with advanced or metastatic HCC were recruited through their physicians for this study. Patient preferences were assessed by using a modified threshold technique (TT) design in which respondents were asked two direct-elicitation questions before (assuming same safety and efficacy and only varying mode of administration) and after (incorporating the safety profiles of ramucirumab and regorafenib) the TT series on seven risks of clinically relevant AEs. RESULTS: In total, of the 157 patients recruited by their physicians, 150 were eligible and consented to participate. In the first elicitation question (assuming risk and efficacy were equivalent), 61.3% of patients preferred daily tablets. However, 76.7% of patients preferred the biweekly infusion when the safety profiles of the two available second-line therapies were included. The TT analysis confirmed that preferences for oral administration were not strong enough to balance out the risk of AEs that differentiate the two therapies. DISCUSSION: We found that when patients were asked to choose between a daily, oral medication and a biweekly IV medication for HCC, they were more likely to choose a daily, oral medication if efficacy and safety profiles were the same. However, when risks of AEs representing the safety profiles of two currently available second-line treatments were introduced in a second direct-elicitation question, respondents often selected an IV administration with a safety profile similar to ramucirumab, rather than oral tablets with a safety profile similar to regorafenib. Our findings indicate that the risk profile of a second-line treatment for HCC may be more important than the mode of administration to patients. CI - (c) 2023. Eli Lilly & Company. FAU - Parikh, Neehar D AU - Parikh ND AD - Division of Gastroenterology and Hepatology, University of Michigan Health System, Ann Arbor, MI, USA. FAU - Girvan, Allicia AU - Girvan A AD - Eli Lilly and Company, Indianapolis, IN, USA. FAU - Coulter, Joshua AU - Coulter J AD - RTI Health Solutions, Research Triangle Park, NC, USA. FAU - Gable, Jonathon AU - Gable J AD - Eli Lilly and Company, Indianapolis, IN, USA. FAU - Poon, Jiat Ling AU - Poon JL AD - Eli Lilly and Company, Indianapolis, IN, USA. FAU - Kim, Sangmi AU - Kim S AD - Eli Lilly and Company, Indianapolis, IN, USA. FAU - Chatterjee, Anindya AU - Chatterjee A AD - Eli Lilly and Company, Indianapolis, IN, USA. FAU - Boeri, Marco AU - Boeri M AD - RTI Health Solutions, 123B Forsyth House, Cromac Square, Belfast, BT2 8LA, UK. mboeri@rti.org. LA - eng GR - N/A/Eli Lilly and Company/ GR - N/A/Eli Lilly and Company/ GR - N/A/Eli Lilly and Company/ GR - N/A/Eli Lilly and Company/ GR - N/A/Eli Lilly and Company/ GR - N/A/Eli Lilly and Company/ GR - N/A/Eli Lilly and Company/ GR - N/A/Eli Lilly and Company/ PT - Journal Article DEP - 20230119 PL - England TA - BMC Cancer JT - BMC cancer JID - 100967800 RN - 24T2A1DOYB (regorafenib) RN - 0 (Tablets) SB - IM MH - Humans MH - *Carcinoma, Hepatocellular/pathology MH - *Liver Neoplasms/pathology MH - Patient Preference MH - Tablets/therapeutic use PMC - PMC9851100 OTO - NOTNLM OT - Direct-elicitation OT - Hepatocellular carcinoma OT - Patient preferences OT - Threshold technique COIS- NDP has served as a consultant for Bristol Myers-Squibb, Exact Sciences, Eli Lilly, and Freenome; has served on advisory boards of Genentech, Eisai, Bayer, Exelixis, Wako/Fujifilm; and has received institutional research funding from Bayer, Target RWE, Exact Sciences, Genentech, and Glycotest. JC and MB are full-time employees of RTI Health Solutions, an independent nonprofit research organization, which was retained by Eli Lilly and Company to conduct the research that is the subject of this manuscript. Their compensation is unconnected to the studies on which they work. JLP, SK, and AC are employees of Eli Lilly and Company and hold shares and/or stock options in the company. AG and JG were employees of Eli Lilly and Company at the time this study was conducted. EDAT- 2023/01/20 06:00 MHDA- 2023/01/24 06:00 PMCR- 2023/01/19 CRDT- 2023/01/19 23:45 PHST- 2022/03/04 00:00 [received] PHST- 2022/11/30 00:00 [accepted] PHST- 2023/01/19 23:45 [entrez] PHST- 2023/01/20 06:00 [pubmed] PHST- 2023/01/24 06:00 [medline] PHST- 2023/01/19 00:00 [pmc-release] AID - 10.1186/s12885-022-10388-8 [pii] AID - 10388 [pii] AID - 10.1186/s12885-022-10388-8 [doi] PST - epublish SO - BMC Cancer. 2023 Jan 19;23(1):66. doi: 10.1186/s12885-022-10388-8.