Preferences for First-Line Chronic Lymphocytic Leukemia Treatments: Results From a Multinational Study on the Perspectives of Patients and Physicians

Bersabeh Sile,1 Dipen Patel,2 Dahbia Horchi,3 Bleuenn Rault,3 Emily Mulvihill,4 Kathleen Beusterien,4 Katherine Stewart,2 Paulo Miranda,2 Xavier Guillaume3 1AstraZeneca, Cambridge, UK; 2AstraZeneca, Gaithersburg, MD, USA; 3Oracle Life Sciences, Paris, France; 4Oracle Life Sciences, North Kansas City, MO, USACorrespondence: Xavier Guillaume, Oracle Life Sciences, 198 Avenue de France, Paris, 75013, France, Tel + 33 6 14 57 45 95, Email [email protected]: Few studies have explored physician and patient preferences for the treatment of chronic lymphocytic leukemia (CLL) related to treatment efficacy, adverse events (AEs), and treatment duration. Thus, this observational, mixed-methods study investigated patients’ and physicians’ preferences for CLL first-line treatments.Materials and Methods: An online discrete choice experiment in five countries among 192 patients and 259 physicians in the US, the UK, Germany, France, and Australia examined the importance of outcomes and treatment attributes.Results: Increasing 5-year progression-free survival (5-year PFS) was most important to patients and physicians, with a relative importance (RI) of 30.3% among patients and 37.8% among physicians, followed by reducing the risks of common side effects (RI 21.6% among patients, 22.9% among physicians) and adverse events (AEs) leading to treatment discontinuation (RI 22.1% among patients, 20.6% among physicians). Patients strongly preferred time limited treatment regimen over treatment to progression (TTP). Specifically, patients and physicians would require a 6.4% vs 2.3% increase in 5-year PFS, a 19.4% vs 8.9% decrease in the risk of common all grades side effects, and a 7.5% vs 3.7% decrease in the risk of treatment discontinuation due to AEs, respectively, to compensate for a daily oral medication taken indefinitely vs daily oral medication taken for 24 months.Conclusion: Overall, patients and physicians favor time-limited treatment regimens over TTP and value treatments with greater PFS benefits followed by lower side effects. Patients and physicians were both willing to trade-off switching from time-limited treatment to TTP for a better 5-year PFS, decrease side effects, and risk of treatment discontinuation due to AEs.Keywords: chronic lymphocytic leukemia, first-line treatment, discrete choice experiment, fixed-duration treatment, patient and physician preferences