Treatment preferences of patients and physicians for early-stage and adjuvant treatment of urothelial carcinoma and renal cell carcinoma in Asia-Pacific: a discrete choice experiment
- Author(s)
- Chiong, E; Spain, L; Patel, MI; Ong, TA; Wang, SS; Tsai, YC; Chan, E; Vandervoort, L; D'Souza, A; Gokhale, S; Teoh, JY;
- Journal Title
- BMC Urology
- Publication Type
- Online publication before print
- Abstract
- INTRODUCTION: The management of early-stage and adjuvant UC and RCC has undergone a paradigm shift with the availability of multiple treatment options. However, there is limited understanding about the treatment attributes preferred by patients and physicians in these settings in Asia-Pacific. METHODS: This cross-sectional web-based discrete choice experiment (DCE) survey aimed to assess treatment preferences for early-stage and adjuvant UC and RCC in Asia-Pacific. Participants were patients (aged ≥ 18 years, RCC: n=50, UC: n=50) and physicians (medical oncologists: n=46; urologists: n=44). The DCE included 8 attributes covering efficacy, risks of treatment-related adverse events (TRAEs), and mode of administration (MOA). Relative preference weights, relative importance (RI), and minimum acceptable benefit were analyzed using hierarchical Bayesian logistic regression. RESULTS: Both patients and physicians placed higher importance on efficacy attributes: one-year disease-free survival (DFS) (patients: RI=25.1%; physicians: RI=36.3%) and overall survival (OS) (patients: RI=27.6%; physicians: RI=22.1%). Among patients, this was followed by risks of treatment-related fatigue (RI=9.9%), and risk of long-term/permanent TRAEs (RI=9.4%). For physicians, it was risk of treatment-related skin rash (RI=8.5%) and risk of treatment-related fatigue (RI=8.0%). Patients would accept a 5-35% risk increase in treatment-related fatigue for 11.4% DFS/0.67-year OS increase, and a 1-15% risk increase in long-term/permanent TRAE (1%-15%) for 10.8% DFS/0.64-year OS increase. Physicians would accept 5-25% risk increases in treatment-related skin rash for 8.0% DFS/0.74-year OS increase and in fatigue for 6.1% DFS/0.56-year OS increase. Most patients (87-92%) and physicians (88-96%) would initiate earlier systemic treatment for UC/RCC than at the advanced or metastatic stage. CONCLUSION: Patients and physicians valued efficacy attributes over TRAE-attributes. Both groups would trade higher risks for greater efficacy, though these trade-offs vary based on TRAE type. This indicates a need for shared decision-making for early-stage and adjuvant UC and RCC in Asia-Pacific.
- Keywords
- Asia-Pacific; Discrete choice experiment; Early-stage and adjuvant setting; Renal cell carcinoma; Treatment preference; Urothelial carcinoma
- Department(s)
- Medical Oncology
- Publisher's Version
- https://doi.org/10.1186/s12894-025-02043-8
- Open Access at Publisher's Site
https://doi.org/10.1186/s12894-025-02043-8- Terms of Use/Rights Notice
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Creation Date: 2026-01-20 12:06:14
Last Modified: 2026-01-20 12:06:31