Prospective patient preference study for Bruton tyrosine kinase inhibitor (BTKi) treatment attributes and factors affecting patient shared decision-making in chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL) in the United States (US)

Background A comprehensive quantitative analysis was conducted to examine patient preferences for chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL) treatment attributes.Research design and methods A discrete choice experiment survey was conducted in United States patients with CLL/SLL. Treatment attributes (efficacy, safety, convenience) were identified through literature review and clinical input. Attributes’ relative importance and patients’ willingness to trade off attributes were calculated using conditional logistic regression.Results Among 200 respondents, attributes with the highest to the lowest importance were impact of atrial fibrillation on quality of life (QoL; 23.9%); progression-free survival (PFS; 18.6%); impacts of headache (17.7%), diarrhea (14.3%), hypertension (13.6%) on QoL; dosing frequency (8.8%); and formulation type (3.1%). Patients preferred treatments with higher efficacy, less impact of AEs on QoL, lower dosing frequency, and tablets over capsules (p < 0.05). Patients were willing to trade off 2.57 and 1.91 years of PFS for less impact of atrial fibrillation and headache on QoL, respectively.Conclusions Findings suggest that among treatment attributes assessed, the most important attributes for CLL/SLL patients were impact of atrial fibrillation on QoL, PFS, and impact of headache on QoL. Shared decision-making in treatment selection should include informed discussion about efficacy and impact of AEs on QoL.