Study: Prior Treatment for Ovarian Cancer Influences Patient Preferences Regarding Adverse Effects, Maintenance Treatments

With new and varying options for maintenance therapy in patients with ovarian cancer, patients may express a preference when discussing potential maintenance treatments and their adverse effects.

With new and varying options for maintenance therapy in patients with ovarian cancer, patients may express a preference when discussing potential maintenance treatments and their adverse effects (AEs). In an effort to better understand what influences those preferences, experts analyzed the decisions of patients with advanced-stage ovarian cancer.

During in-person, structured interviews, a team of researchers asked patients to rate descriptions of AEs associated with chemotherapy and maintenance therapy, with 0 being the most bothersome and 100 being the least bothersome. They were also asked to evaluate the decision-making factors associated with consideration of maintenance therapy, with 0 being the least important and 100 being the most important.

A total of 34 patients were included, with a median age of 64 years. Of the total patients, 53% had recurrent ovarian cancer and 62% had maintenance therapy. According to their findings, patients with prior bevacizumab (BEV) treatment were less bothered by hypertension and anemia than patients without a history of BEV. Similarly, patients with a history of poly ADP-ribose polymerase inhibitor (PARPi) treatment were less bothered by pneumonitis than patients without that experience.

Interestingly, the investigators found that patients with a college education or more were less bothered by all AEs than patients with lower educational levels, most notably for fatigue, rash, and changes in taste.

Among the list of AEs, thyroid problems were rated as the most bothersome with a score of 67.5, whereas bowel perforation was the least bothersome with a score of 0.5. The top 3 most concerning AEs were thyroid problems, skin rash, and peripheral neuropathy.

For factors influencing decision-making, the investigators found no differences based on prior treatment with BEV or PARPi, but patients with prior maintenance therapy viewed the need for additional medications as more important than patients who had never had maintenance therapy. Again, patients with lower education levels viewed all decision-making factors as more important than patients with a college education or more.

The most important decision factor was physician’s recommendation, with a score of 100, whereas the least important was indirect costs with a score of 61.5. The top 3 most influential decision factors included physician’s recommendation, treatment efficacy, and potential AEs.

The authors concluded that although prior treatment certainly appears to influence patient preferences for different AEs, demographic factors such as marital status and education level also influence their decisions and should be considered by clinicians.

REFERENCE

SP81 — Patient preferences for side effects and decision-making factors associated with maintenance therapy for ovarian cancer. SGO Conference Website. Published March 31, 2020. https://sgo.confex.com/sgo/2020/meetingapp.cgi/Paper/15004. Accessed June 19, 2020.