Patient and Oncologist Preferences for the Treatment of Adults with Advanced Soft Tissue Sarcoma: A Discrete Choice Experiment

  • Jasmina Ivanova
  • Lisa M. HessEmail author
  • Viviana Garcia-Horton
  • Sophia Graham
  • Xinyue Liu
  • Yajun Zhu
  • Steven Nicol
Original Research Article



There has been no single standard-of-care treatment of patients with advanced/metastatic soft tissue sarcoma (STS). This study was designed to understand patient and oncologist preferences in the advanced/metastatic setting.


Adult patients diagnosed with STS and oncologists treating patients with STS completed discrete choice experiment surveys. Study participants chose between pairs of hypothetical treatment profiles for advanced STS characterized by varying levels of overall survival (14, 20, or 26 months), progression-free survival (3, 5, or 7 months), objective tumor response rate (12, 18, or 26%), risk of hospitalization due to side effects (12, 30, or 46%), and days/month to administer treatment (1, 2, or 4 days). A hierarchical Bayes model was used to estimate preferences and relative importance of attributes.


Seventy-six patients (23.7% male, mean age 52.8 years) and 160 oncologists (73.8% male, mean 16.9 years in practice) completed the surveys. Among patients, overall survival had the highest relative importance (39.5%, standard deviation [SD] 18.2%), followed by response rate (21.2%, SD 10.4%), and hospitalization (19.8%, SD 12.5%). Among oncologists, overall survival had the highest relative importance (44.6%, SD 16.0%), followed by hospitalization (18.4%, SD 8.3%).


Both patients with STS and oncologists preferred a treatment that maximizes the life of patients while avoiding hospitalizations.


Author contributions

All authors made significant contributions to the study design, analysis and interpretation of the data, and preparing and reviewing the manuscript. All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this manuscript, take responsibility for the integrity of the work as a whole, and have given final approval of the version to be published. All authors had full access to all of the data presented in this study and take complete responsibility for the integrity of the data and accuracy of the data analysis.


Research funding was provided by Eli Lilly and Company to Analysis Group, Inc.

Compliance with ethical standards

Ethical approval

All study procedures were reviewed and approved as exempt under 45 CFR §46.101(b)(2) by the Western Institutional Review Board, Puyallup, WA, USA. Informed consent was obtained from all individual participants included in the study.

Conflict of interest

Lisa M. Hess, Yajun Zhu, and Steven Nicol are employees of Eli Lilly and Company. Jasmina Ivanova, Viviana Garcia-Horton, Sophia Graham, and Xinyue Liu are employees of Analysis Group, Inc.

Supplementary material

40271_2019_355_MOESM1_ESM.docx (12 kb)
Supplementary material 1 (DOCX 11 kb)


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Analysis Group, Inc.New YorkUSA
  2. 2.Eli Lilly and CompanyIndianapolisUSA
  3. 3.Analysis Group, Inc.Menlo ParkUSA

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