Evaluation of the relative importance of chemotherapeutic and antiemetic efficacy in various oncologic settings.
OBJECTIVE
This study investigated physician's attitudes toward the relative importance of chemotherapeutic and antiemetic efficacy in different clinical scenarios.


METHODS
Oncologists in the USA and four European countries completed an online stated-choice survey consisting of three hypothetical treatment choices for each of two patient types. Each hypothetical treatment alternative included both chemotherapy and antiemetic regimens. The two hypothetical patient types were (1) a 48-year-old woman with locoregional infiltrating ductal carcinoma of the breast and (2) a 78-year-old man with squamous cell carcinoma of the lung and multiple liver metastases. In each choice question, oncologists were asked to select the better combination of chemotherapy and antiemetic prophylaxis between two treatment alternatives.


RESULTS
Five hundred fifty-seven oncologists completed the survey. For the adjuvant breast cancer patient, the most aggressive chemotherapy is consistently the most important treatment consideration in all countries. For the advanced lung cancer patient, the most aggressive chemotherapy, the less aggressive chemotherapy, and the most aggressive antiemetic prophylaxis are of similar importance in most countries.


CONCLUSIONS
Physicians appear more likely to prescribe a more aggressive chemotherapy regimen for a younger patient with a perceived curable tumor, regardless of the emetogenic properties of the chemotherapy. Symptom management is more of a concern and chemotherapeutic efficacy relatively less of a priority in an older patient with advanced disease for whom chemotherapy is not curative.
Ettinger
David S
DS
The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, 1650 New Orleans Street, Baltimore, MD 21231, USA.
Grunberg
Steven M
SM
Hauber
A Brett
AB
Mohamed
Ateesha F
AF