Patient preferences for triple-class–exposed relapsed or refractory multiple myeloma treatment: a discrete-choice study

Abstract

Aims: To quantify patient preferences for attributes of novel treatments for triple-class–exposed (TCE) relapsed and/or refractory multiple myeloma (RRMM). Methods: Using a discrete-choice experiment, we elicited preferences for 7 attributes: objective response rate (ORR), overall survival (OS), all-grade cytokine release syndrome risk, all-grade immune effector cell–associated neurotoxicity syndrome risk, serious infection risk (grade 3+), treatment administration, and initial hospitalization requirements. Results: OS was the most important attribute (conditional relative importance [CRI] 32.0% for a 24-month increase), followed by serious infection risk (CRI 17.3% for avoiding a 60% risk), initial hospitalization requirements (CRI 15.0% for avoiding 14 days of initial hospitalization), and ORR (CRI 13.7% for a 38% increase). Based on differences between relative preference weights, fewer initial hospitalization days when starting treatment and off-the-shelf (vs. chimeric antigen receptor T [CAR T] cell–like) options were significantly preferred. Conclusions: Therapy decisions for patients with TCE RRMM should consider tradeoffs between efficacy, safety, and attributes related to treatment process and initial monitoring.