The Bottom Line:
New survey data shows that the most important treatment attribute for patients with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL) is that the treatment increases their chances of progression-free survival at two years. Patients also preferred oral treatments over IV treatments and fixed-duration treatments over treat-to-progression treatments.
Who Performed the Research and Where Was it Presented:
Dr. Brian Koffman from the CLL Society and colleagues presented the results at the American Society for Hematology Annual Meeting in 2022.
The treatment of CLL / SLL has changed dramatically as we have moved from chemotherapies, which broadly kill rapidly dividing cells, to targeted therapies, which target specific genes and proteins that help cancer cells survive and grow. As a result, many different kinds of therapies are now available to patients, and it is important to understand patient treatment preferences.
In this interview, Dr. Alexey Danilov, Associate Director of the Toni Stephenson Lymphoma Center at the City of Hope in Duarte, CA, interviewed Dr. Brian Koffman, Executive Vice President, and Chief Medical Officer of the CLL Society. They discussed the results of a new survey study of patient treatment preferences.
Methods and Participants:
This survey was a web-based discrete-choice experiment. Recruitment was done through the CLL Society. Participants answered 12 questions, each offering a choice between two hypothetical treatment profiles based on specific treatment attributes. The survey was conducted in 2022, and 229 adults in the United States with a self-reported diagnosis of CLL for at least three months completed the survey.
- The most crucial attribute for patients was increasing the chance of progression-free survival at two years from 70% to 90% and confirming results with MRD testing instead of routine testing.
- Patients preferred daily oral pills over IV infusions every four weeks.
- Patients preferred fixed-duration treatments over treat-to-progression treatments.
- Less important attributes included the risk of tumor lysis syndrome, atrial fibrillation, and fatigue.
- There may be some bias, as the respondents to this survey are likely highly engaged with their care.
The most important treatment attribute for patients with CLL / SLL was that the treatment increases their chances of progression-free survival at two years. Based on these results, probably the most appealing therapy to patients would be one that is oral, limited-duration, and gets patients to undetectable measurable residual disease (which is a surrogate for progression-free survival). As always, patients must be involved in treatment decisions; asking them is the best way to find out what they want.
Links and Resources:
Watch the interview on the abstract here:
You can read the actual ASH abstract here: Understanding Patient Preferences for Chronic Lymphocytic Leukemia Treatments
Take care of yourself first.
Ann Liu, PhD