Mansfield C, Myers K, Klein K, Patel J, Nakasato A, Ling YL, Tarhini AA. Risk tolerance in adjuvant and metastatic melanoma settings: a patient perspective study using the threshold technique. Future Oncol. 2021 Jun;17(17):2151-67. doi: 10.2217/fon-2020-1193

BACKGROUND: Adverse events (e.g., pyrexia) may affect treatment patterns and adherence. This study explored pyrexia risk tolerance among melanoma patients when treatment benefit is unknown versus known.

MATERIALS & METHODS: US respondents with stage III (n = 100) or stage III unresectable/stage IV melanoma (n = 125) chose between hypothetical melanoma treatments, defined by reoccurrence/progression-free survival and pyrexia risk, one resembling standard-of-care and one resembling dabrafenib + trametinib. Respondents chose first when efficacy was unknown and then when efficacy was known; pyrexia risk was varied systematically to define maximum acceptable risk.

Maximum acceptable risk of pyrexia was statistically significantly higher when efficacy was known versus unknown in stage III patients (85 vs 34%) and stage III unresectable/stage IV patients (66 vs 57%).

CONCLUSION: Patients accepted higher levels of pyrexia risk when they understood treatment benefit.

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