Balancing Patient and Caregiver Priorities in NSCLC Treatment

For patients with ALK-rearranged non–small cell lung cancer (ALK+ NSCLC), choosing a treatment involves balancing significant benefits and risks, especially since therapies are often long term. A study presented at the 2025 American Society of Clinical Oncology (ASCO) Annual Meeting explored how patients and caregivers weigh these factors when making treatment decisions.

Researchers, including Christopher Danes, PhD, conducted an online discrete choice experiment with 205 ALK+ NSCLC patients and 125 caregivers. Participants repeatedly chose between 2 hypothetical treatments characterized by seven benefit/risk attributes, including 3-year progression-free survival (PFS) and various adverse events.

The results showed that both patients and caregivers overwhelmingly prioritized 3-year PFS. While adverse events were less important, most patients and caregivers were willing to accept a reduction in PFS to minimize certain risks. For instance, patients were willing to trade 3.9-8.7% of 3-year PFS to reduce risks like cognitive/mood effects, abnormal lab results, and lung complications. Caregivers showed similar willingness to trade for some risks, but not all. Notably, a minority of both groups (around 30%) based their choices solely on PFS, and a subset of caregivers were unwilling to trade any benefit for reduced risks.

"Through this [experiment], you can kind of get a sense of how impactful those [adverse effects] are to them. And so looking at it from both the patient and caregivers perspective is really important, because sometimes what a patient experiences and what a caregiver observes are 2 different things, and it's really why having a patient and a caregiver part of the decision-making process is actually really valuable, because they can observe what's going on, what's important to them, and what's really impactful," Danes, scientific director, Global Medical Affairs Oncology, at Takeda Oncology said in an interview with Targeted Oncology^TM.

The study concludes that open discussions between physicians, patients, and caregivers are essential to consider individual preferences regarding the balance between treatment benefits and potential risks.

REFERENCE:

Danes C, Seo J, Trapali M, et al. Patient and caregiver treatment preferences for ALK+ non-small cell lung cancer in the United States. Presented at: 2025 ASCO Annual Meeting; May 30-June 3, 2025; Chicago, IL. Abstract 8617.