Oncologists’ preferences for first-line treatment of ALK-positive metastatic NSCLC in the United States: a discrete choice experiment
Year: 2025
Type: article
Study design: Observational Study
Abstract: OBJECTIVE: Tradeoffs between efficacy, safety, and administration may influence decision-making for first-line (1L) treatments for ALK+ mNSCLC. This study explored heterogeneity in provider preferences. METHODS: A survey of US oncologists treating ≥1 ALK+ mNSCLC patient was conducted June-August 2024. Participants answered 12 questions comparing 1 L profiles characterized by eight treatment attributes for patients without brain metastases. Attributes included 3-year PFS, intracranial duration of response (iDOR), 16-month risk of edema, myalgia, or cognitive effects, grade ≥3 interstitial lung disease/pneumonitis, 2 L+ treatment options, and administration. Relative attribute importance (RAI) (0-100%) was calculated for aggregate efficacy and safety attributes. Latent class analysis (LCA) explored preference heterogeneity and differences in respondent characteristics. RESULTS: In total, 201 oncologists completed the discrete choice experiment. Oncologists emphasized the efficacy over safety (RAI = 47.0% vs 39.0%). LCA identified two classes, placing similar importance on efficacy (RAI = 44.5% vs 48.2%) and safety (RAI = 39% vs 41.2%), but preferring different levels in five attributes. Class 1 oncologists (61%) preferred 3-year PFS of 64% over 43-46%, while Class 2 oncologists (39%) did not differentiate. Conversely, Class 2 focused on iDOR. CONCLUSION: We identified two oncologist groups with distinct preferences for treatment attributes. Given various 1 L ALK+ mNSCLC treatments, clinical decision-making balances multiple objectives.
Source: Future Oncology
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W4416134328