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For people with early-stage non-small cell lung cancer, expanding treatment options are welcome news—but they can also make decisions more complicated. Some aggressive treatments may improve the chance of remaining cancer-free, while also adding months or years of therapy, infusion visits, side effects, or the need for help with daily activities. Because researchers are still working to understand which patients are most likely to require an aggressive treatment regimen, patients’ preferences can be a key factor when making these treatment plans. A poster presented at the 2026 World Conference on Lung Cancer in Seoul, South Korea, explored what people value most when weighing these trade-offs.
The study, led by Duke University’s Clinical Research Institute and presented by Bellinda King-Kallimanis, PhD, of LUNGevity Foundation, used a discrete-choice experiment survey designed with clinical experts and patient advocates and refined through cognitive pretesting. The survey included 133 respondents: 47 people with resectable non-small cell lung cancer from the Duke Cancer Registry and 86 people undergoing screening through the Duke Lung Cancer Screening Program.
Key findings included:
- Overall, improving 5-year disease-free survival was the most important factor in deciding between the differing treatment options.
- Some respondents were willing to accept a lower chance of being cancer-free at five years in exchange for less burdensome side effects or shorter treatment duration.
- Patients were much less willing to accept treatments that left them needing help from others, especially when those treatments lasted longer. In those cases, they wanted to see a greater benefit to make the trade-off worthwhile.
In other words, patients did not evaluate treatment benefit in isolation. Event-free survival mattered most, but the burden of treatment was also important, particularly when side effects could affect their independence. These findings suggest that people may think differently about a one-year treatment than a three-year treatment, or about side effects that slow them down compared with side effects that require help from others for daily activities.
“Patient preferences are a key element in perioperative treatment selection,” said Dr. King-Kallimanis. “Due to the risk of over treatment in this space right now, how treatments fit into a person’s life, responsibilities, and priorities is also key.”
Takeaway and next steps: As more treatment options become available for early-stage lung cancer, shared decision-making should include clear conversations about expected benefit, treatment duration, side effects, and the potential impact on independence. Understanding what patients are willing to trade (and what is non-negotiable) can help align treatment recommendations with the outcomes that matter most to them.
Want to learn more about the patient perspective? Email Bellinda King-Kallimanis, PhD, Vice President of the Patient-Focused Research Center at LUNGevity Foundation at [email protected].