Grant: Project Grant

Progression-Free survival (PFS) time is a common outcome in cancer clinical trials. PFS indicates how long treatment keeps a cancer under control (e.g., before x-rays show worsening). New therapies are often approved on the basis of offering longer PFS, often without information about whether patients live any longer (overall survival, OS) or their quality of life (QOL). Since many treatments have side effects, their value is unclear if only PFS is prolonged. The goals are to 1) gather patient's attitudes and preferences for cancer treatments under certain combinations of treatment attributes (e.g. length of PFS and amount of side-effects) using both established trade-off methods and interview (qualitative) methods; 2) to identify which elements of the treatment attributes are most relevant to patients; 3) to use these findings to inform multi-stakeholder driven research designed to generate next-step research on a larger scale. Patients with advanced cancer will participate in a 1:1 interview in Kingston or Ottawa. The interviewer will explain a new hypothetical scenario, related outcomes, and treatment attributes. Patients will weigh preferences for treatments with different attributes (e.g., side effects and impact on PFS) and respond to open-ended questions about their preferences. The findings will inform a multi-stakeholder process for designing additional research on a larger scale that will be useful from the knowledge-user and patient perspectives. The project could impact health services in many ways, including: understanding how patients value undesirable treatment impact vs its impact on duration of PFS, and informing health-economic assessment of value of therapies that have isolated PFS benefits. Understanding the cancer outcome endpoints that are most meaningful to patients is crucial for decision-making around which new treatments are priorities to offer, and in the design of new trials aimed at improving outcomes.