Longer PFS, Fewer AEs, Less Invasiveness Top Patient Preferences in NET Treatments

A recent study of treatment preferences in patients with neuroendocrine tumor (NET) suggests most patients may prioritize longer cancer control over other treatment attributes. However, many patients prioritize treatments that confer fewer side effects or a lower level of invasiveness. These study results were reported in The Oncologist.

In this study, patients with NET participated in discrete choice experiments (DCEs) to explore their preferences regarding advanced midgut and pancreatic NET (pNET) treatment options. 

This study had a primary objective of determining relative utility rankings for various aspects of treatment, such as progression-free survival (PFS), treatment modality, and rates of adverse events (AEs). The study investigators also linked certain attribute profiles with various treatments and estimated preferences for these therapy options. 

For this study, 110 patients participated in a DCE regarding midgut NET and 132 patients participated in a DCE regarding pNET. Median ages of participants were 61.5 years and 63.0 years in the midgut NET DCE and the pNET DCE, respectively. The majority of patients in each group had a primary gastrointestinal tumor, and most had metastatic or locally advanced disease.

Of the participants in the midgut NET DCE, 64.5% ranked longer PFS as the most important treatment attribute. Of those in the pNET DCE, 59.0% ranked PFS as most important. Among participants in both DCEs, the remaining patients considered having lower AE rates or treatment of a less invasive nature as being of a higher priority than PFS. 

When considering particular treatment profiles, the investigators estimated that 60.9% of patients in the midgut NET DCE would prefer peptide receptor radionuclide therapy (PRRT). They also estimated that 30.0% of this group would favor somatostatin analogue dose escalation therapy, and 7.3% would prefer everolimus therapy.

For patients in the pNET DCE, the investigators estimated that most (81.8%) would prefer CAPTEM therapy. They also estimated that 15.9% of this group would prefer everolimus therapy, and 0.0% would prefer sunitinib therapy.

“These results highlight that knowledge of patient preferences should be incorporated into trial endpoints, trial design, and regulatory considerations in order to drive research that focuses on delivering outcomes of value to a diverse patient population,” the investigators wrote in their report. 

Disclosures: Some authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.

Reference

Anaka M, Chan D, Pattison S, et al. Patient priorities concerning treatment decisions for advanced neuroendocrine tumors identified by discrete choice experiments. Oncologist. Published online November 25, 2023. doi:10.1093/oncolo/oyad312