Mansfield C, Myers K, Klein K, Patel J, Nakasato A, Ling YL, Tarhini AA. Risk tolerance in adjuvant and metastatic melanoma settings: a patient perspective study using the threshold technique. Future Oncol. 2021 Jun;17(17):2151-67. doi: 10.2217/fon-2020-1193

BACKGROUND: Adverse events (e.g., pyrexia) may affect treatment patterns and adherence. This study explored pyrexia risk tolerance among melanoma patients when treatment benefit is unknown versus known.

MATERIALS & METHODS: US respondents with stage III (n = 100) or stage III unresectable/stage IV melanoma (n = 125) chose between hypothetical melanoma treatments, defined by reoccurrence/progression-free survival and pyrexia risk, one resembling standard-of-care and one resembling dabrafenib + trametinib. Respondents chose first when efficacy was unknown and then when efficacy was known; pyrexia risk was varied systematically to define maximum acceptable risk.

RESULTS: Maximum acceptable risk of pyrexia was statistically significantly higher when efficacy was known versus unknown in stage III patients (85 vs 34%) and stage III unresectable/stage IV patients (66 vs 57%).

CONCLUSION: Patients accepted higher levels of pyrexia risk when they understood treatment benefit.