Preferences for first-line treatment of advanced urothelial carcinoma among US practicing oncologists and patients

Plain language summaryDifferent treatments are available for people with urothelial cancer that has spread to other parts of the body. Researchers wanted to find out what specialist cancer doctors and people with urothelial cancer think is important when choosing the first treatment. To do this, researchers asked 150 cancer specialists and 150 people with urothelial cancer to complete an internet questionnaire. It included questions about side effects, if treatment could help people live longer, and how often people would need to be treated. Researchers found that cancer specialists think that helping people live longer is the most important. However, people with advanced urothelial cancer think that having fewer severe side effects is the most important. Aim: Investigate oncologist and patient preferences for the first-line treatment of advanced urothelial carcinoma. Materials & methods: A discrete-choice experiment was used to elicit treatment attribute preferences, including patient treatment experience (number and duration of treatments and grade 3/4 treatment-related adverse events), overall survival and treatment administration frequency. Results: The study included 151 eligible medical oncologists and 150 patients with urothelial carcinoma. Both physicians and patients appeared to prefer treatment attributes related to overall survival, treatment-related adverse events and the number and duration of the medications in a regimen over frequency of administration. Overall survival had the most influence in driving oncologists' treatment preferences, followed by the patient's treatment experience. Patients found the treatment experience the most important attribute when considering options, followed by overall survival. Conclusion: Patient preferences were based on treatment experience, while oncologists preferred treatments that prolong overall survival. These results help to direct clinical conversations, treatment recommendations and clinical guideline development.