Title: Scoping Review of Values Elicitation Tools for Treatment Decisions in Hepatocellular
Carcinoma
Version: 1 Date: 13 Dec 2023
Reviewer's report:
In this study, the authors conduct a scoping review to assess the evidence base for the
use of preference elicitation tools or willingness to pay/willingness to accept methods for
hepatocellular carcinoma (HCC) treatment decision-making from both the patient and provider
perspective. Overall, ten published abstracts/manuscripts addressed the role of preference
elicitation tools for HCC treatments. Many of the studies reviewed revealed that while patients
place the most value on extending their overall survival (OS), they are willing to forgo OS
to avoid risks of treatments and maintain quality of life. Studies of physicians and surgeons
found that provider preferences are dependent on patient characteristics, provider specialty,
and surgeon or hospital-related factors. They concluded that studies revealed a large scope of
potential attributes that may be important for patients and that many patients are willing to forgo
survival to maintain quality of life.
The study is of interest since HCC treatment decision-making process may be affected by
several factors and mantaining acceptable quality of life is a very clinically relevant end-point
to consider in HCC treatment, particularly for palliative, non-curative, treatments.
In my opinion, the clinical impact of this study could be improved by taking into account
also studies evaluating the safety and efficacy of alternative systemic treatments for HCC
patients because of their suboptimal performance status, as well as patients' preference on
accepting potential drug-related side effects/toxicities. In this regard, it was recently reported
the good safety and efficacy profile of systemic treatments with metronomic capecitabine
in patients who not tolerated or were unresponsive to sorafenib, as recently demonstrated
in cohort studies (Metronomic capecitabine as second-line treatment in hepatocellular
carcinoma after sorafenib failure. Dig Liver Dis. 2015 Jun;47(6):518-22. doi: 10.1016/
j.dld.2015.03.010; Metronomic capecitabine as second-line treatment for hepatocellular
carcinoma after sorafenib discontinuation. J Cancer Res Clin Oncol. 2018 Feb;144(2):403-414.
doi: 10.1007/s00432-017-2556-6. ).
Title: Scoping Review of Values Elicitation Tools for Treatment Decisions in Hepatocellular
Carcinoma
Version: 1 Date: 13 Dec 2023
Reviewer's report:
In this study, the authors conduct a scoping review to assess the evidence base for the
use of preference elicitation tools or willingness to pay/willingness to accept methods for
hepatocellular carcinoma (HCC) treatment decision-making from both the patient and provider
perspective. Overall, ten published abstracts/manuscripts addressed the role of preference
elicitation tools for HCC treatments. Many of the studies reviewed revealed that while patients
place the most value on extending their overall survival (OS), they are willing to forgo OS
to avoid risks of treatments and maintain quality of life. Studies of physicians and surgeons
found that provider preferences are dependent on patient characteristics, provider specialty,
and surgeon or hospital-related factors. They concluded that studies revealed a large scope of
potential attributes that may be important for patients and that many patients are willing to forgo
survival to maintain quality of life.
The study is of interest since HCC treatment decision-making process may be affected by
several factors and mantaining acceptable quality of life is a very clinically relevant end-point
to consider in HCC treatment, particularly for palliative, non-curative, treatments.
In my opinion, the clinical impact of this study could be improved by taking into account
also studies evaluating the safety and efficacy of alternative systemic treatments for HCC
patients because of their suboptimal performance status, as well as patients' preference on
accepting potential drug-related side effects/toxicities. In this regard, it was recently reported
the good safety and efficacy profile of systemic treatments with metronomic capecitabine
in patients who not tolerated or were unresponsive to sorafenib, as recently demonstrated
in cohort studies (Metronomic capecitabine as second-line treatment in hepatocellular
carcinoma after sorafenib failure. Dig Liver Dis. 2015 Jun;47(6):518-22. doi: 10.1016/
j.dld.2015.03.010; Metronomic capecitabine as second-line treatment for hepatocellular
carcinoma after sorafenib discontinuation. J Cancer Res Clin Oncol. 2018 Feb;144(2):403-414.
doi: 10.1007/s00432-017-2556-6. ).
Please review this paper.
user
Title: Scoping Review of Values Elicitation Tools for Treatment Decisions in Hepatocellular
Carcinoma
Version: 1 Date: 13 Dec 2023
Reviewer's report:
In this study, the authors conduct a scoping review to assess the evidence base for the
use of preference elicitation tools or willingness to pay/willingness to accept methods for
hepatocellular carcinoma (HCC) treatment decision-making from both the patient and provider
perspective. Overall, ten published abstracts/manuscripts addressed the role of preference
elicitation tools for HCC treatments. Many of the studies reviewed revealed that while patients
place the most value on extending their overall survival (OS), they are willing to forgo OS
to avoid risks of treatments and maintain quality of life. Studies of physicians and surgeons
found that provider preferences are dependent on patient characteristics, provider specialty,
and surgeon or hospital-related factors. They concluded that studies revealed a large scope of
potential attributes that may be important for patients and that many patients are willing to forgo
survival to maintain quality of life.
The study is of interest since HCC treatment decision-making process may be affected by
several factors and mantaining acceptable quality of life is a very clinically relevant end-point
to consider in HCC treatment, particularly for palliative, non-curative, treatments.
In my opinion, the clinical impact of this study could be improved by taking into account
also studies evaluating the safety and efficacy of alternative systemic treatments for HCC
patients because of their suboptimal performance status, as well as patients' preference on
accepting potential drug-related side effects/toxicities. In this regard, it was recently reported
the good safety and efficacy profile of systemic treatments with metronomic capecitabine
in patients who not tolerated or were unresponsive to sorafenib, as recently demonstrated
in cohort studies (Metronomic capecitabine as second-line treatment in hepatocellular
carcinoma after sorafenib failure. Dig Liver Dis. 2015 Jun;47(6):518-22. doi: 10.1016/
j.dld.2015.03.010; Metronomic capecitabine as second-line treatment for hepatocellular
carcinoma after sorafenib discontinuation. J Cancer Res Clin Oncol. 2018 Feb;144(2):403-414.
doi: 10.1007/s00432-017-2556-6. ).
assistant