OBJECTIVES: To understand patient preferences for treatment attributes in stage II/III and stage IV melanoma in the UK and determine predictive factors for treatment preferences in different subpopulations.

METHODS: Patients with stage II–IV melanoma were recruited via multi-channel direct-to-patient approach to complete a 30-minute online survey comprising two discrete choice experiments (DCE). Each DCE was presented to all patients regardless of their disease stage and included a series of choice tasks between two hypothetical treatments comprising seven attributes for clinical endpoints of efficacy, safety, and dosing regimen from randomized clinical trials. Hierarchical Bayesian modeling was used to estimate preference weights for each attribute level and relative attribute importance (RI).

RESULTS: Overall, 104 patients were recruited from November 2022 to February 2023. DCEs for adjuvant (Adj-DCE) and metastatic (Met-DCE) treatments were completed by 100 and 102 patients, respectively. Mean patient age was 52 years; 33% of patients had stage IV melanoma and 51% were estimated to have BRAF mutation. In the Adj-DCE group, 4-year relapse-free survival (RFS) and risk of grade ≥3 adverse events (AE) had a similar RI: 33% and 29%, respectively. In the Met-DCE group, the difference between 4-year overall survival (OS) and risk of grade ≥3 AE was 40% and 26%, respectively. Efficacy attributes had a higher RI for stage IV versus stage II/III patients; similarly, BRAF mutated patients had a higher RI for efficacy attributes versus BRAF wild-type patients (data not shown).

CONCLUSIONS: These findings suggest that patient’s perception of treatment efficacy and safety may be influenced by the disease stage: while relative perception of treatment efficacy and safety is similar in early disease, in metastatic disease treatment efficacy stands as the most important factor for patients. This study helps to better understand how patients perceive different attributes associated with approved melanoma treatments in the UK.