Supplementary Material for: Patient Preferences: Results of a German Adaptive Choice-Based Conjoint Analysis (Market Research Study Sponsored by Eli Lilly and Company) in Patients on Palliative Treatment for Advanced Breast Cancer

<b><i>Introduction:</i></b> Integration of patient preferences into shared decision making improves disease-related outcomes, but such data from patients with advanced breast cancer (aBC) are limited. The objective of this study was to demonstrate the relative importance of overall survival (OS) and progression-free survival (PFS) in relation to quality of life (QoL) and therapy-associated side effects from the perspective of patients with aBC. <b><i>Methods:</i></b> Postmenopausal patients with hormone receptor-positive, human epidermal growth factor receptor 2-negative aBC receiving first- or second-line treatment were recruited throughout Germany. Patient-relevant attributes for aBC therapy assessment were collected using a stepwise multimodal approach. A conjoint matrix was developed, resulting in 2 attributes for therapy goals (OS and PFS), 4 for QoL, and 6 for side effects. An online quantitative survey was then performed using adaptive choice-based conjoint (ACBC) methodology. <b><i>Results:</i></b> The quantitative survey included 104 patients: 67 (64.4%) receiving first-line treatment and 37 (35.6%) receiving second-line treatment. The QoL attribute “physical agility and mobility” received the highest utility score (19.4 of 100%), reflecting the greatest importance to patients, followed by treatment goals (OS [15.2%] and PFS [14.4%]). Therapy-related side effects were less important, with nausea/vomiting being the most important (9.3%), followed by infection (6.4%) and hair loss (5.0%). The McFadden pseudo <i>R</i>² (0.805), the root likelihood (0.864), and the χ² test (2,809.041; <i>p</i> &lt; 0.0001) indicated a very good fit of the statistical model. <b><i>Conclusion:</i></b> Using ACBC analysis, it appears that QoL, OS, and PFS are most important to postmenopausal patients with aBC in relation to cancer treatment. Side effects seem to be less important if OS or PFS are prolonged and the QoL is maintained. Thus, QoL, OS, and PFS should be considered equally when making treatment decisions in aBC.

**引言：** 将患者偏好纳入共同决策可改善疾病相关转归，但晚期乳腺癌（advanced breast cancer, aBC）患者的此类相关数据仍较为有限。本研究旨在从晚期乳腺癌患者的视角，阐明总生存期（overall survival, OS）、无进展生存期（progression-free survival, PFS）相较于生活质量（quality of life, QoL）及治疗相关不良反应的相对重要性。
**方法：** 本研究在全德范围内招募了接受一线或二线治疗的激素受体阳性、人表皮生长因子受体2（human epidermal growth factor receptor 2）阴性的绝经后晚期乳腺癌患者。采用逐步多模态方法收集用于晚期乳腺癌治疗评估的患者相关属性指标，构建联合分析矩阵，最终确定治疗目标相关属性2项（OS与PFS）、生活质量相关属性4项，以及不良反应相关属性6项。随后采用自适应选择联合分析（adaptive choice-based conjoint, ACBC）方法开展了在线定量调查。
**结果：** 本次定量调查共纳入104例患者，其中67例（64.4%）接受一线治疗，37例（35.6%）接受二线治疗。生活质量维度中“身体活动能力与行动灵活性”的效用得分最高（100分制下为19.4分），体现了患者对此项指标的最高重视度；其次为治疗目标维度（OS为15.2%，PFS为14.4%）。治疗相关不良反应的重要性相对较低，其中恶心/呕吐为最受关注的不良反应（9.3%），其次为感染（6.4%）与脱发（5.0%）。麦克法登伪决定系数（McFadden pseudo R²）为0.805、似然根（root likelihood）为0.864，卡方检验（χ² test）结果为2809.041（p < 0.0001），均表明该统计模型拟合效果极佳。
**结论：** 通过自适应选择联合分析可知，对于绝经后晚期乳腺癌患者而言，生活质量、总生存期与无进展生存期是癌症治疗中最为重要的考量因素。若能延长OS或PFS并维持患者的生活质量，则治疗相关不良反应的重要性相对较低。因此，在晚期乳腺癌的治疗决策中，应同等重视生活质量、OS与PFS。