title: Patient preferences in advanced or recurrent ovarian cancer.
abstract: BACKGROUND
  The objective of this study was to elucidate relative preferences of women with ovarian cancer for symptoms, treatment-related side effects, and progression-free survival (PFS) relevant to choosing a treatment regimen.
  
  
  METHODS
  Women with advanced or recurrent ovarian cancer participated in a survey that included 3 methods to measure patient preferences (ratings, rankings, and a discrete-choice experiment) for 7 attributes: mode of administration, visit frequency, peripheral neuropathy, nausea and vomiting, fatigue, abdominal discomfort, and PFS. Participants were asked to choose between 2 unlabeled treatment scenarios that were characterized using the 7 attributes. Each participant completed 12 choice questions in which attribute levels were assigned according to an experimental design and a fixed-choice question representing 2 chemotherapy regimens for ovarian cancer.
  
  
  RESULTS
  In total, 95 women completed the survey. Participants' ratings and rankings revealed greater concern and importance for PFS than for any other attribute (P < .0001 for all). The discrete-choice experiment revealed that the relative odds that a participant would choose a scenario with 18 months, 21 months, and 24 months of PFS versus 15 months of PFS were 1.5 (P = .01), 3.4 (P < .001), and 7.5 (P < .001), respectively. However, participants' choices indicated that they were willing to accept a shorter PFS to avoid severe side effects: 6.7 months to reduce nausea and vomiting from severe to mild, 5.0 months to reduce neuropathy from severe to mild, and 3.7 months to reduce abdominal symptoms from severe to moderate.
  
  
  CONCLUSIONS
  PFS is the predominant driver of patient preferences for chemotherapy regimens. However, women in the current study were willing to trade significant PFS time for reductions in treatment-related toxicity.
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina; Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina.
authors.forename: Laura J
authors.initials: LJ
authors.lastname: Havrilesky
authors.forename: Angeles
authors.initials: A
authors.lastname: Alvarez Secord
authors.forename: Jessie A
authors.initials: JA
authors.lastname: Ehrisman
authors.forename: Andrew
authors.initials: A
authors.lastname: Berchuck
authors.forename: Fidel A
authors.initials: FA
authors.lastname: Valea
authors.forename: Paula S
authors.initials: PS
authors.lastname: Lee
authors.forename: Stephanie L
authors.initials: SL
authors.lastname: Gaillard
authors.forename: Greg P
authors.initials: GP
authors.lastname: Samsa
authors.forename: David
authors.initials: D
authors.lastname: Cella
authors.forename: Kevin P
authors.initials: KP
authors.lastname: Weinfurt
authors.forename: Amy P
authors.initials: AP
authors.lastname: Abernethy
authors.forename: Shelby D
authors.initials: SD
authors.lastname: Reed
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects*; D002755:Choice Behavior; D018572:Disease-Free Survival; D005221:Fatigue / Q000139:chemically induced; D005260:Female; D006801:Humans; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000523:psychology / Q000628:therapy*; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000523:psychology; D057240:Patient Preference; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced; D014839:Vomiting / Q000139:chemically induced
chemical_list: D000970:Antineoplastic Agents
keywords: chemotherapy; ovarian cancer; patient preferences; progression-free survival; side effects
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