Shared Decision-Making for DLBCL Treatment

Patients with relapsed or refractory diffuse large B-cell lymphoma (R/R DLBCL) may benefit from shared decision-making with their caregivers and physicians, especially for second- or third-line treatment, according to study results presented at the American Society of Clinical Oncology’s 2022 annual meeting.  

Semi-structured interviews were conducted with 14 adult R/R DLBCL patients, 8 caregivers, and 8 oncologists. All of the 1-hour long interviews were coded prior to analysis.

Low self-efficacy for shared decision-making was reported in 71% of patients and 38% of caregivers. Patients reported rapid-moving care and shock of diagnosis/failing treatment as reasons that obstructed their involvement in shared decision-making for treatment. However, patients also reported they felt they were following a well-established standard of care, relying on physician recommendations for first-line treatment. Caregivers considered treatment decisions as directives.

For second- and third-line treatment, a cumulative treatment experience impacted patient preferences and considerations, with 43% of patients reporting higher autonomy over decision-making and clearer expectations. Educational materials around treatment options were shared by 71% of the patients’ oncologists. Additional resources for managing ancillary concerns such as mental health and fertility were desired by some patients.

Satisfaction with their treatment experience was reported by 71% of study participants, but 21% reported wanting a more individualized approach.

Limited treatment options, established standard of care, and lack of patient understanding were among the barriers physicians listed for involving patients in decision-making.

“Results suggest while second- and third-line R/R DLBCL treatment options may be limited, patient preferences and goals can be incorporated into long-term treatment planning,” researchers concluded. “Opportunities for improvement include developing tailored educational materials for caregivers to establish them as trusted messengers and physician tools to support integration of patients’ lived experiences into their clinical workflow.”

—Leigh Precopio

Reference:

Vukcevic M. Patient, caregiver, and physician preferences for treatment of relapsed or refractory diffuse large B-cell lymphoma (R/R DLBCL). Paper presented at: 2022 ASCO Annual Meeting; June 3-7, 2022; Chicago, IL. Accessed June 9, 2022. https://meetings.asco.org/abstracts-presentations/206260