OBJECTIVES: With the rise of targeted therapy for specific genetic alterations tumor agnostic therapy (TAT) is becoming more common. Preferences for TAT are not well-studied. The aim of this study was to develop a quantitative preference elicitation instrument to assess patient preferences for a TAT targeting solid tumors with fibroblast growth factor receptor alterations currently being investigated for use in patients who have progressed on at least one line of therapy and for whom no standard treatment options remain.

METHODS: Qualitative, semi-structured interviews were conducted with eight patients in Europe with locally advanced or metastatic cholangiocarcinoma, pancreatic, or urothelial cancer. Themes covered were informed by synthesis of clinical data on comparator treatment across cancer types, other TATs, and companion or diagnostic testing approaches.

RESULTS: Extending progression free survival (PFS) and overall survival (OS) were key treatment benefits identified by patients. Half of patients indicated that their physician had described the benefits of their current or most recent treatment regimen in terms of PFS outcomes and three had discussed OS with their physician. Five participants reported having undergone genetic testing related to their cancer, but most were unable to differentiate this from biomarker testing and did not have a clear understanding of how results could be used to inform treatment selection. All patients indicated a willingness to undergo biopsy and additional testing for a targeted treatment with superior OS, however; in describing their reasoning, participants conflated test accuracy and testing modality with treatment benefit, and assumed additional non treatment-related benefits of testing.

CONCLUSIONS: Assessment of preferences for TATs is unique in several respects. Treatment eligibility must first be established via diagnostic procedure, patient outcomes are linked to correct identification of alteration status and correct treatment allocation, and the relative value of a treatment for each patient may vary according to differing comparator sets.