Patient preferences for adjuvant therapy in renal cell carcinoma: a discrete-choice experiment

To quantify patients’ preferences for adjuvant renal cell carcinoma (RCC) treatments. Preferences were elicited using a discrete-choice experiment requiring RCC patients to choose between 2 hypothetical treatments. Data were analyzed using random-parameters logit and latent-class models. Patients (<i>n</i> = 250) preferred treatments that increase disease-free and overall survival (OS), are taken less frequently, require no concomitant medication, have a shorter duration, and have lower side-effect risks. The analyses also highlighted their willingness to make tradeoffs between these benefits and risks. Patients were generally tolerant of increases in the risks of treatment-related severe diarrhea, dizziness, and fatigue and were willing to accept increases in these risks in exchange for improvements in overall or disease-free survival. Latent-class analysis identified 3 classes: class 1 (37.5%) and class 2 (26.9%) preferred not to opt out of treatment and prioritized increased OS and disease-free survival, respectively; class 3 (35.5%) preferred to opt out and prioritized mode, duration, and risks. Heterogeneity suggests patient-physician discussions are important when considering RCC treatments. Renal cell carcinoma is a kind of kidney cancer that is hard to treat. Patients with renal cell carcinoma often have surgery to remove the tumor. New treatments are being developed that can be taken after surgery, when patients are free from cancer, to lower the risk of their cancer returning. We wanted to know how patients balanced the benefits, risks, and other features of these treatments. In a survey, we asked patients with kidney cancer to make tradeoffs by choosing their preferred option from a series of hypothetical treatments (with different features) that could be taken after surgery. Their choices revealed to us which features were most important to them and their willingness to trade off among the different treatment features. On average, the most important treatment feature for patients was increasing the chance of living for at least 5 more years after starting treatment (overall survival). However, our analyses determined that some patients felt differently. Some felt that living cancer-free was most important, whereas others were most concerned about how the treatment was taken and the potential for side effects.