Tremendous advances have been achieved in the understanding of cancer biology, with cancer researchers extolling the potential of precision medicine in tailoring treatment to specific tumor markers. However, instead of feeling empowered, patients often have difficulty comparing and selecting among various treatment options.1 Compounding this perplexity is the rising cost of cancer therapies coupled with continued concerns about side effects and their impact on quality of life (QOL). Although incremental improvements in overall survival remain the most important consideration when selecting a particular treatment, additional critical considerations are needed for proper therapeutic choosing. This delicate balance has recently been translated into so-called “value” in cancer care. Although frameworks to better understand and practice “value in cancer care” have been developed,2 these tools have not actively involved patients. To create an effective model of value in oncology care, the views and needs of all stakeholders must be aligned with those of the patients. To that end, we propose a patient-centered value framework as a mechanism of optimizing cancer care moving forward (Figure 1).
Livaudais J, Franco R, Fei K et al.. Breast cancer treatment decision-making: are we asking too much of patients? J Gen Intern Med 2013;28:630–636.
Schnipper LE, Davidson NE, Wollins DS et al.. American Society of Clinical Oncology statement: a conceptual framework to assess the value of cancer treatment options [published online ahead of print June 22, 2015]. J Clin Oncol; pii: JCO.2015.61.6706.
Goetghebeur MM, Wagner M, Khoury H et al.. Combining multicriteria decision analysis, ethics and health technology assessment: applying the EVIDEM decision-making framework to growth hormone for Turner syndrome patients. Cost Eff Resour Alloc 2010;8:4.
Tempero MA, Malafa MP, Behrman SW et al.. NCCN Clinical Practice Guidelines in Onocology for Pancreatic Adenocarcinoma. Version 2.2014. J Natl Compr Canc Netw 2014;12:1083–1093.
de Souza JA, Yap BJ, Hlubocky FJ et al.. The development of a financial toxicity patient-reported outcome in cancer: the COST measure. Cancer 2014;120:3245–3253.
Kehl KL, Landrum MB, Arora NK et al.. Association of actual and preferred decision roles with patient-reported quality of care: shared decision making in cancer care. JAMA Oncol 2015;1:50–58.
Kane HL, Halpern MT, Squiers LB et al.. Implementing and evaluating shared decision making in oncology practice. CA Cancer J Clin 2014;64:377–388.