Oncologists' and urologists' preferences for adjuvant therapy in renal cell carcinoma

Abstract

INTRODUCTION: To quantify physicians' preferences for adjuvant renal cell carcinoma (RCC) treatments.

MATERIALS AND METHODS: A discrete-choice experiment was administered online to board-certified/eligible physicians. Physicians chose between pairs of hypothetical adjuvant therapies for a high-risk patient who had recently undergone a radical nephrectomy. Data were analyzed using random-parameters logit and latent-class models.

RESULTS: Physicians (n = 250; 64% oncologists; 36% urologists) placed most importance on improvements in the chance of 5-year overall survival, followed by increased median disease-free survival and reduced risk of side effects. The analyses also highlighted their willingness to make tradeoffs between these benefits and risks. Physicians 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. Subgroup analysis revealed heterogeneity between oncologists and urologists, and latent-class analysis revealed significant heterogeneity among the whole physician sample.

CONCLUSIONS: Most physicians in this study would recommend adjuvant therapy to a typical high-risk postnephrectomy RCC patient.