OBJECTIVES: BRAF-MEK inhibitor combination targeted therapies offer a personalized treatment approach for melanoma patients with a BRAF+ V600E/K mutation. This study quantified metastatic melanoma patient preferences for treatment attributes that differ among various BRAF-MEK combination targeted therapy options.

METHODS: US patients with self-reported metastatic melanoma completed an online discrete choice experiment (DCE). Choice tasks were based on key treatment attributes: 1) dosing requirements (number of pills/schedule) 2) food requirements, 3) efficacy (progression-free survival), 4) fever, 5) photosensitivity, and 6) diarrhea. Differentiating attributes (features) and levels (options) were identified based on a targeted literature review, including review of approved product labels for marketed BRAF-MEK therapies: vemurafenib-cobimetinib (V-C), dabrafenib-trametinib (D-T), and encorafenib-binimetinib (E-B). Furthermore, survey content finalization was informed by in-depth qualitative interviews with 12 patients (to assess comprehension and importance to refine the draft attribute list) and incorporated input from an expert oncologist. Hierarchical Bayesian estimation was used to calculate preference weights to estimate relative importance of attributes and to simulate preference share across pre-defined BRAF-MEK therapy profiles.

RESULTS: The final sample (N=142) had a median age of 49 years and was majority female (78%). Patients reported being BRAF-positive (44%), BRAF-negative (27%), or unknown (29%). Efficacy was the most important attribute (27.3%) followed by safety (fever [22.5%], diarrhea [19.7%] being more important than photosensitivity [12.8%]). Regimen attributes such as dosing requirements (10.8%) and food requirements (7.0%) were least important. Simulated preference shares indicated patients’ preference for the E-B profile over D-T and V-C profiles. Sensitivity analyses were performed and demonstrated robustness of the findings.

CONCLUSIONS: Considering all attributes tested in this DCE, findings suggest E-B may offer the most preferred treatment profile by metastatic melanoma patients. Future studies may be warranted to achieve a more in-depth understanding on treatment attributes important for shared decision-making between metastatic melanoma patients and healthcare providers.