Exploring decisional needs of patients considering first line treatment of advanced EGFR+ lung cancer: An interpretive descriptive study.

Abstract

8612 Background: With expanding treatment options for EGFR+ metastatic non-small cell lung cancer (mNSCLC), shared decision-making is important in aligning treatment plans with patient values. Targeted therapies like osimertinib offer convenience and independence. New studies like FLAURA2 and MARIPOSA explore therapeutic combinations with intravenous drugs, demonstrating potentially superior efficacy but more side effects, highlighting the need for unbiased and patient-centered approaches. This study explores the decisional needs of patients considering first-line treatments. Methods: We conducted an interpretive descriptive qualitative study guided by the Ottawa Decision Support Framework to explore the experiences and perspectives of EGFR+ mNSCLC patients. Interviews were conducted via Microsoft Teams. Inclusion criteria: 18+ years; mEGFR+ NSCLC; current/prior osimertinib therapy; proficient in English. Interviews were conducted using a standardized interview guide with inductive thematic analysis. A sample size of 10-12 was considered sufficient to saturate ideas from participant responses, with additional 3 recruited to ensure saturation. Themes were mapped onto the Ottawa Decision Support Framework. Results: Sixteen participants were interviewed from Sep-Nov 2024: age 48-83 (median 62 years); 11 female; 13 currently taking osimertinib; 10 diagnosed >1 year. Many patients reported relying on oncologist recommendation without participation in decision making. Patients with young children had an increased desire to be actively involved in treatment decisions. Key themes from preliminary analysis identified: patients overwhelmingly trusted their oncologist , felt pressure to start treatment quickly , were overwhelmed with the diagnosis , had inadequate knowledge of the treatment and potential side effects, and felt highly responsible to ensure proper drug administration . Patients valued e ase and convenience of [osimertinib] treatment, fe w severe side effects, being alive, continuing day to day living , and remaining independent for family and travel. When asked about combination therapy, patients valued quality of life , avoiding increased hospital trips and side effects , but indicated a willingness to try . Conclusions: Key themes from preliminary analysis identify crucial components at initial diagnosis, with patients feeling overwhelmed and having inadequate knowledge, thus relying on their trusted oncologists’ recommendation. While patients highly valued independence, fewer visits and quality of life, they were willing to try combination therapy, highlighting the importance of oncologists understanding their patient’s individual needs and goals of treatment. Treatment choices should reflect the patient’s values. These results will be used to create a decision aid that we can pilot in our oncology clinics.