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

Future Oncol. 2025 Mar;21(7):853-865. doi: 10.1080/14796694.2025.2461430. Epub 2025 Feb 26.

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.

Keywords: BCMA bispecific antibody; BCMA-directed immunotherapy; CAR T cell therapy; conjoint analysis; discrete-choice experiment; patient preference; triple-class exposed relapsed/refractory multiple myeloma.

MeSH terms

  • Adult
  • Aged
  • Choice Behavior
  • Cytokine Release Syndrome / epidemiology
  • Cytokine Release Syndrome / etiology
  • Drug Resistance, Neoplasm
  • Female
  • Humans
  • Immunotherapy, Adoptive / adverse effects
  • Immunotherapy, Adoptive / methods
  • Male
  • Middle Aged
  • Multiple Myeloma* / drug therapy
  • Multiple Myeloma* / mortality
  • Multiple Myeloma* / therapy
  • Neoplasm Recurrence, Local*
  • Patient Preference* / statistics & numerical data
  • Treatment Outcome