PREFERENCES FOR TARGETED THERAPY ATTRIBUTES AMONG CHINESE PATIENTS WITH ALK-POSITIVE ADVANCED NON-SMALL CELL LUNG CANCER: A DISCRETE CHOICE EXPERIMENT
Author(s)
Lei Wang, MS1, Ying-dan Cao, MS1, Xiaodong Liu, BS2, Yao Xue Lin, PhD2, Caicun Zhou, PhD3, Yu Fang, PhD2.
1School of Pharmacy, Xi'an Jiaotong University, Xian, China, 2School of Pharmacy, Xi'an Jiaotong University, Xi'an, China, 3Tongji University School of Medicine, Shanghai East Hospital, Shanghai, China.
1School of Pharmacy, Xi'an Jiaotong University, Xian, China, 2School of Pharmacy, Xi'an Jiaotong University, Xi'an, China, 3Tongji University School of Medicine, Shanghai East Hospital, Shanghai, China.
OBJECTIVES: To quantify treatment preferences among Chinese patients with ALK-positive advanced non-small cell lung cancer (NSCLC) with prior ALK tyrosine kinase inhibitors (ALK-TKI) therapy.
METHODS: An online discrete choice experiment (DCE) was conducted from May to June 2025 through a national patient organization. Seven attributes with three levels each: median progression-free survival (PFS), objective response rate (ORR), constipation, central nervous system (CNS) adverse events, rash, liver injury, and monthly treatment cost. An orthogonal fractional factorial design generated nine choice sets with two treatment alternatives and an opt-out option. A quality-control task and consistency checks were applied. Data were analyzed using mixed logit models to evaluate relative importance, choice probability, risk-benefit trade-offs, and subgroup variations.
RESULTS: Of 269 questionnaires, 251 met prespecified quality criteria. Safety profiles dominated patient preferences, with liver injury (28.02%) and CNS adverse events (22.46%) carrying the highest relative importance, followed by ORR (17.93%). Patients favored higher ORR and longer PFS, with ORR yielding greater preference weights. Elevating ORR from 70% to 80% and 90% increased choice probability by 14.17% and 17.36%, respectively, whereas extending median PFS from 30 months to 60 months increased it by 11.87%. Notably, ORR improvements could offset moderate CNS adverse events or liver injury, whereas PFS extensions could not. Neither severe CNS adverse events nor severe liver injury could be compensated for by efficacy gains. Subgroup analyses showed that females, patients with comorbidities, patients with stage IV disease, and those who had received only one prior ALK-TKI exhibited stronger avoidance of moderate CNS adverse events.
CONCLUSIONS: Preferences for ALK-TKI treatments among Chinese patients are primarily dictated by hepatic and neurological safety, followed by ORR benefits. These findings offer pivotal insights for patient-centered clinical decision-making and preference-informed evaluations of ALK-TKIs.
METHODS: An online discrete choice experiment (DCE) was conducted from May to June 2025 through a national patient organization. Seven attributes with three levels each: median progression-free survival (PFS), objective response rate (ORR), constipation, central nervous system (CNS) adverse events, rash, liver injury, and monthly treatment cost. An orthogonal fractional factorial design generated nine choice sets with two treatment alternatives and an opt-out option. A quality-control task and consistency checks were applied. Data were analyzed using mixed logit models to evaluate relative importance, choice probability, risk-benefit trade-offs, and subgroup variations.
RESULTS: Of 269 questionnaires, 251 met prespecified quality criteria. Safety profiles dominated patient preferences, with liver injury (28.02%) and CNS adverse events (22.46%) carrying the highest relative importance, followed by ORR (17.93%). Patients favored higher ORR and longer PFS, with ORR yielding greater preference weights. Elevating ORR from 70% to 80% and 90% increased choice probability by 14.17% and 17.36%, respectively, whereas extending median PFS from 30 months to 60 months increased it by 11.87%. Notably, ORR improvements could offset moderate CNS adverse events or liver injury, whereas PFS extensions could not. Neither severe CNS adverse events nor severe liver injury could be compensated for by efficacy gains. Subgroup analyses showed that females, patients with comorbidities, patients with stage IV disease, and those who had received only one prior ALK-TKI exhibited stronger avoidance of moderate CNS adverse events.
CONCLUSIONS: Preferences for ALK-TKI treatments among Chinese patients are primarily dictated by hepatic and neurological safety, followed by ORR benefits. These findings offer pivotal insights for patient-centered clinical decision-making and preference-informed evaluations of ALK-TKIs.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
P29
Topic
Health Technology Assessment, Methodological & Statistical Research, Patient-Centered Research
Disease
Oncology