Japanese patient preferences regarding intermediate to advanced hepatocellular carcinoma treatments - PubMed (original) (raw)

. 2019 Apr 30:13:637-647.

doi: 10.2147/PPA.S198363. eCollection 2019.

Atsushi Hiraoka 2, Shigeru Mikami 3, Masami Shinozaki 4, Yukio Osaki 5, Masamichi Obu 6, Takamasa Ohki 7, Naoyuki Mita 8, Dianne Ledesma 8, Nariaki Yoshihara 8, Kathleen Beusterien 9, Kaitlan Amos 9, John Fp Bridges 10, Osamu Yokosuka 11

Affiliations

Japanese patient preferences regarding intermediate to advanced hepatocellular carcinoma treatments

Tetsuhiro Chiba et al. Patient Prefer Adherence. 2019.

Abstract

Purpose: This study aimed to evaluate Japanese patient preferences regarding features of intermediate or advanced (Progressed) hepatocellular carcinoma (HCC) treatments: transarterial chemoembolization (TACE), hepatic arterial infusion chemotherapy (HAIC), and oral anti-cancer therapy. Methods: Patients with HCC, recruited from clinical sites and a patient panel in Japan, completed a cross-sectional web-based survey. Preferences were quantified using best-worst scaling, where patients identified the best and worst among 13 treatment features. Direct elicitation was used to identify preference for TACE, HAIC, or oral therapy, including the likelihood of trying each. Additional items asked for the willingness to try an oral medication that delays progression by six months but has an 8% or 21% risk of severe hand-foot skin reaction (HFSR). Results: The sample (N=119; 29 early stage; 90 Progressed) most preferred "oral medication", "artery branches plugged", and "prevents formation of new blood vessels", and least preferred "risk of liver damage" and "risk of catheter-related complications". Overall, 51%, 40%, and 8% preferred oral therapy, TACE, and HAIC, respectively (p<0.05), and the mean likelihood of trying each were 59%, 52%, and 35%, respectively (p<0.001). Patients with sorafenib or TACE experience most preferred what they had received; however, both groups were equally willing to try the other treatment. Patients preferring oral therapy favored "oral medication" over "artery branches plugged", "surgery is repeated as required when the cancer grows again", and "risk of liver damage", compared to those preferring TACE (p<0.05). Sixty-eight percent would probably try therapy with an 8% risk of severe HFSR, compared to 50% with a 21% risk. Conclusion: Treatment type, mode of action, and risks may drive HCC patient preferences. Such features likely should be incorporated into physician-patient interactions regarding treatment decision-making.

Keywords: best-worst scaling; hepatocellular carcinoma; patient preference.

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Conflict of interest statement

T. Chiba reports commercial research funding from Bayer Yakuhin, Ltd. He also reports grants from Bayer Inc., during the conduct of the study and outside the submitted work. N. Mita, D. Ledesma, and N. Yoshihara are employees of Bayer Yakuhin, Ltd. K. Beusterien and K. Amos worked for ORS Health, which provided consulting services to Bayer Yakuhin, Ltd. during this study. J. Bridges has consulted for Bayer and has received travel support from Bayer. He also received personal fees from ORS Health, during the conduct of the study. T. Ohki reports personal fees from Bayer Yakuhin, personal fees from Eisai, outside the submitted work. O. Yokosuka reports personal fees from BMS, personal fees from Bayer, grants from Eisai, Takeda, Chugai, MSD, DS Pharma, Daiichi-Sankyo, Astellas, Asahi-kasei, Tanabe, and Nipponkayaku, outside the submitted work. The authors report no other conflicts of interest in this work.

Figures

Figure 1

Figure 1

Example best–worst scaling item.

Figure 2

Figure 2

Direct preference elicitation item. Abbreviations: TACE, Transarterial chemoembolization; HAIC, hepatic arterial infusion chemotherapy.

Figure 3

Figure 3

Mean best-worst scaling (BWS) scores for each feature: overall sample.

Figure 4

Figure 4

Best–worst scaling scores by the number of TACE procedures (≤3 vs >3). Note: *p<0.05 between groups. Abbreviation: TACE, transarterial chemoembolization.

Figure 5

Figure 5

Most preferred treatment by treatment experience. Abbreviations: TACE, transarterial chemoembolization; HAIC, hepatic arterial infusion chemotherapy.

Figure 6

Figure 6

Proportions willing to try oral therapy with 6-month progression-free survival by severe risk of hand-foot skin reaction (HFSR).

Figure 7

Figure 7

Mean MAR of severe events by time to progression. Abbreviations: HFSR, hand-foot skin reaction; MAR, maximum acceptable risk.

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