Risk tolerance in adjuvant and metastatic melanoma settings: a patient perspective study using the threshold technique

Future Oncol. 2021 Jun;17(17):2151-2167. doi: 10.2217/fon-2020-1193. Epub 2021 Mar 12.

Abstract

Background: Adverse events (e.g., pyrexia) may affect treatment patterns and adherence. This study explored pyrexia risk tolerance among melanoma patients when treatment benefit is unknown versus known. Materials & methods: US respondents with stage III (n = 100) or stage III unresectable/stage IV melanoma (n = 125) chose between hypothetical melanoma treatments, defined by reoccurrence/progression-free survival and pyrexia risk, one resembling standard-of-care and one resembling dabrafenib + trametinib. Respondents chose first when efficacy was unknown and then when efficacy was known; pyrexia risk was varied systematically to define maximum acceptable risk. Results: Maximum acceptable risk of pyrexia was statistically significantly higher when efficacy was known versus unknown in stage III patients (85 vs 34%) and stage III unresectable/stage IV patients (66 vs 57%). Conclusion: Patients accepted higher levels of pyrexia risk when they understood treatment benefit.

Keywords: maximum acceptable risk; melanoma; pyrexia; real-world; stated preferences; threshold technique.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Chemotherapy, Adjuvant / adverse effects*
  • Cross-Sectional Studies
  • Female
  • Fever / chemically induced
  • Fever / epidemiology
  • Fever / pathology*
  • Follow-Up Studies
  • Humans
  • Imidazoles / administration & dosage
  • Male
  • Melanoma / drug therapy*
  • Melanoma / pathology
  • Middle Aged
  • Neoplasm Metastasis
  • Oximes / administration & dosage
  • Prognosis
  • Pyridones / administration & dosage
  • Pyrimidinones / administration & dosage
  • Risk-Taking*
  • Surveys and Questionnaires
  • Survival Rate
  • United States / epidemiology
  • Young Adult

Substances

  • Imidazoles
  • Oximes
  • Pyridones
  • Pyrimidinones
  • trametinib
  • dabrafenib