O1-152 * WHICH DO PATIENTS WITH NSCLC HARBORING EGFR MUTATION PREFER EGFR-TKI OR CHEMOTHERAPY? A VIGNETTES STUDY (LOGIK0903)

Background: The standard first line therapy in advanced NSCLC with EGFR mutation is both EGFR-TKI and chemotherapy. Objective: To determine the preferences of patients for EGFR-TKI or chemotherapy as first-line therapy, and compare to those in physicians or medical staffs. Methods: Three vignettes (paper and DVD case descriptions), varying on three clinical characteristics, were designed to assess the patients', the physicians' or medical staffs' preferences for treatment decision-making and the reason behind the decision. Two written questionnaires to investigate the status of anxiety/depression and the quality of life (QOL) using HADS and FACT-L respectively were performed. Results: Total 387 individuals containing 106 patients, 100 physicians, and 181 medical staffs took part in this study, but six patients and four medical stuffs were excluded for analysis because of the lack of response to the questionnaires. Three hundred and twenty-two patients (85.4%) out of all participants those are analyzed in this study preferred to EGFR-TKI than chemotherapy as a first line therapy if they were in the situation of having a lung cancer harboring EGFR mutation. Preference rate of EGFR-TKI in patients was statistically significantly lower than those in physicians and medical staffs, 73%, 88% and 91%, respectively. Among the reasons we investigated, therapeutic efficacy was the only marginal significant reason for preference in patients. In addition to efficacy, type of drug administration and influence from the therapy to ordinary life were the significant reasons for their preference in physicians. In pre-planned analysis, we found the difference of reason between the patients and the physicians in the value of "influence to ordinary life". The patients preferred EGFR-TKI because of the possibility for continuation of their work or housekeeping, while the physicians did due to the possibility for continuation of having a fun or a habit. The relationship between those outcome and HADS / FACT-L is under analysis. Conclusion: The patients may prefer EGFR-TKI as a first line therapy to chemotherapy as well as physicians and medical staffs. However the reasons of those preferences may be different. We should consider continuation of patients' ordinary life when we need discuss several treatment options with patients.