ArticleFuture oncology (London, England)2025
Oncologists' preferences for frontline TKI treatment of Ph+ acute lymphoblastic leukemia: a discrete choice experiment.
Article in Future oncology (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
aimsTo evaluate hematologist-oncologists' preferences for frontline treatment of Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL) using tyrosine kinase inhibitors (TKIs) + chemotherapy. PARTICIPANTS &
methodsAn online discrete choice experiment was conducted among US-based hematologist-oncologists. Participants viewed profiles of hypothetical TKI + chemotherapy treatments with varied levels of benefit and risks (minimal residual disease-negative complete remission [MRD-negative CR], arterial occlusive events, grade 3-4 hepatotoxicity, grade 3-4 hematotoxicity) and chose their recommended treatment for five patient profiles: "less-complex" baseline; age ≥ 65; ECOG score 3; diabetes; hypertension. Data were analyzed using mixed multinomial logit models.
results121 hematologist-oncologists participated. Increasing MRD-negative CR was most important to hematologist-oncologists, driving 65%-87% of decision-making across patient profiles. Relative importance of benefits/risks varied by patient profile. Pooled across patient profiles, hepatotoxicity was the most concerning risk, driving 14% of decision-making. Based on PhALLCON data and elicited preferences, hematologist-oncologists were predicted to select the profile of ponatinib + chemotherapy over imatinib + chemotherapy for all included patient profiles. Predicted probabilities of choosing ponatinib over imatinib ranged from 87%-98% across patient profiles.
conclusionsHematologist-oncologists prioritized achieving MRD-negative CR when recommending frontline treatments for Ph+ ALL, accepting some risks if offset by meaningful improvement in MRD-negative CR.
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