Contributions
Abstract: PB1687
Type: Publication Only
Background
Data on the key drivers of initial treatment choice for patients diagnosed with acute myeloid leukemia (AML) in the United States is limited. The use of age as a selection driver of induction therapy is well established; however, there is limited data and a knowledge gap about additional factors driving treatment selection.
Aims
This analysis explored the key physician drivers, which led to the selection of high- and low-intensity induction therapy in AML patients.
Methods
Data from the Adelphi AML Disease Specific Programme, a real-world, cross-sectional survey conducted between February–May 2015, was analyzed. A total of 61 hematologists/oncologists provided attitudinal information about their management and treatment choices for AML patients via survey. Each physician was provided a pre-specified list of 16 patient characteristics. Via two separate questions, they were asked to select those considered important when choosing high and low intensity chemotherapy for their AML patients. Characteristics were analysed descriptively and ranked based on the frequency of mention from highest to lowest.
Results
The top three drivers for decision making when selecting high and low intensity treatment were: patient age, performance status and presence of comorbidities. More than 60% of physicians would prescribe high-intensity treatment to patients aged under 65, with a good performance status or with no comorbid conditions. Over half of physicians would consider those who are eligible for a stem cell transplant or have a mutation in the CEBPA gene to be eligible for high-intensity chemotherapy (Table). Low-intensity chemotherapy was considered by more than 60% of physicians as being the most appropriate treatment for patients aged ≥65, with a poor performance status or increased number of comorbid conditions. A total of 38% of physicians would likely consider low-intensity chemotherapy if the patient was ineligible for a stem cell transplant or had had previous cancers or exposure to radiation/chemotherapy in the past.
Top 5 drivers of selection | Total Physicians (N=61) |
High-intensity chemotherapy | |
Patients aged <65 years | 41 (67%) |
Good performance status (ECOG score 0-1) | 39 (64%) |
Patients without comorbidities | 37 (61%) |
Patients eligible for stem cell transplant | 33 (54%) |
Patients with mutation in the CEBPA gene | 33 (54%) |
Low-intensity chemotherapy | |
Patients aged ≥65 years | 41 (67%) |
Very poor / poor performance status (ECOG score 2+) | 38 (62%) |
Patients with comorbidities | 38 (62%) |
Patients ineligible for stem cell transplant | 23 (38%) |
Patients with prior cancers / previous to radiation therapy or chemotherapy | 23 (38%) |
Conclusion
Irrespective of treatment intensity, patient age, performance status and the presence of comorbidities are the top three drivers of treatment selection for physicians. In addition to patient age, identification of the other key drivers for therapy selection and the physician awareness of them is critical to ensure patients receive the most appropriate therapy. This improved awareness could also lead to better communication tools for patients and improve shared decision-making.
Session topic: 4. Acute myeloid leukemia - Clinical
Keyword(s): Induction chemotherapy, AML
Abstract: PB1687
Type: Publication Only
Background
Data on the key drivers of initial treatment choice for patients diagnosed with acute myeloid leukemia (AML) in the United States is limited. The use of age as a selection driver of induction therapy is well established; however, there is limited data and a knowledge gap about additional factors driving treatment selection.
Aims
This analysis explored the key physician drivers, which led to the selection of high- and low-intensity induction therapy in AML patients.
Methods
Data from the Adelphi AML Disease Specific Programme, a real-world, cross-sectional survey conducted between February–May 2015, was analyzed. A total of 61 hematologists/oncologists provided attitudinal information about their management and treatment choices for AML patients via survey. Each physician was provided a pre-specified list of 16 patient characteristics. Via two separate questions, they were asked to select those considered important when choosing high and low intensity chemotherapy for their AML patients. Characteristics were analysed descriptively and ranked based on the frequency of mention from highest to lowest.
Results
The top three drivers for decision making when selecting high and low intensity treatment were: patient age, performance status and presence of comorbidities. More than 60% of physicians would prescribe high-intensity treatment to patients aged under 65, with a good performance status or with no comorbid conditions. Over half of physicians would consider those who are eligible for a stem cell transplant or have a mutation in the CEBPA gene to be eligible for high-intensity chemotherapy (Table). Low-intensity chemotherapy was considered by more than 60% of physicians as being the most appropriate treatment for patients aged ≥65, with a poor performance status or increased number of comorbid conditions. A total of 38% of physicians would likely consider low-intensity chemotherapy if the patient was ineligible for a stem cell transplant or had had previous cancers or exposure to radiation/chemotherapy in the past.
Top 5 drivers of selection | Total Physicians (N=61) |
High-intensity chemotherapy | |
Patients aged <65 years | 41 (67%) |
Good performance status (ECOG score 0-1) | 39 (64%) |
Patients without comorbidities | 37 (61%) |
Patients eligible for stem cell transplant | 33 (54%) |
Patients with mutation in the CEBPA gene | 33 (54%) |
Low-intensity chemotherapy | |
Patients aged ≥65 years | 41 (67%) |
Very poor / poor performance status (ECOG score 2+) | 38 (62%) |
Patients with comorbidities | 38 (62%) |
Patients ineligible for stem cell transplant | 23 (38%) |
Patients with prior cancers / previous to radiation therapy or chemotherapy | 23 (38%) |
Conclusion
Irrespective of treatment intensity, patient age, performance status and the presence of comorbidities are the top three drivers of treatment selection for physicians. In addition to patient age, identification of the other key drivers for therapy selection and the physician awareness of them is critical to ensure patients receive the most appropriate therapy. This improved awareness could also lead to better communication tools for patients and improve shared decision-making.
Session topic: 4. Acute myeloid leukemia - Clinical
Keyword(s): Induction chemotherapy, AML