Posted: Monday, October 30, 2023
Novel treatment strategies to improve clinical outcomes for patients with multiple myeloma who are ineligible for stem cell transplantation have focused on the short-term risks associated with chimeric antigen receptor T-cell therapy, explained Shelby D. Reed, PhD, RPh, of Duke Clinical Research Institute, Durham, North Carolina, and colleagues. The team presented its findings at the 2023 American Society of Clinical Oncology (ASCO) Quality Care Symposium (Abstract 320), which suggested patients may be willing to accept specified levels of mortality in exchange for increased relapse-free intervals and decreased negative impacts on activities of daily living.
A total of 176 patients with multiple myeloma were recruited from the Duke Cancer Institute Tumor Registry. Patients were asked to complete a discrete-choice experiment survey in which they would assume the role of an individual whose friend was recently diagnosed with multiple myeloma and was ineligible for stem cell transplantation. Patients were asked to choose the best postinduction therapy for their friend, which resulted in variable treatment-related outcomes including time until relapse and extent of treatment-related adverse events.
Collectively, the observed trends demonstrated that patients preferred treatment options with the least amount of risk and maximal amount of benefit. The factor deemed most important by patients surveyed was the avoidance of treatment-related mortality (preference weight [PW] = 3.69). An increased number of relapse-free years (PW = 3.32) and a reduced impact on daily activities (PW = 2.04) were also factors deemed valuable by surveyed patients. However, the risk of reversible, short-term adverse events was not as worrisome for these patients (PW = 0.58). Furthermore, if the time until relapse could increase by 2 years, patients would accept a mortality rate of 5.7%. Similarly, to avoid side effects that might moderately impair their activities of daily living, patients would accept a 6.0% risk of mortality.
Disclosure: For full disclosures of the study authors, visit coi.asco.org.