Patients’ Preferences for the Treatment of Metastatic Castrate-resistant Prostate Cancer: A Discrete Choice Experiment

Abstract

Men with mCRPC consider a wide range of factors when making decisions regarding their treatment. They showed a strong preference for treatment associated with better control of bone pain. They also placed value on treatments that could delay the need for chemotherapy, and they preferred to avoid side effects such as cognition and memory loss, and extreme tiredness. TOMs highlighted the importance of symptom control, even compared with potential side effects. An understanding of the degree to which patients value the attributes associated with various treatment options will assist clinicians and health care professionals when making decisions regarding the management of men with mCRPC.

Patient and caregiver benefit‐risk preferences for nonmetastatic castration‐resistant prostate cancer treatment

“…The DCE assessed two efficacy-related attributes (OS and time to pain progression [TPP]) and five AE-related attributes (frequency or severity of fatigue, skin rash, cognitive problems, risk of serious fall, and risk of serious fracture) ( Table 1). These attributes were selected based on a targeted literature search of preference studies in prostate cancer and clinical trials of SGARIs, [11][12][13][22][23][24][25][26][27] and individual phone interviews with five nmCRPC-treating physicians, five nm-CRPC patients, and five caregivers of nmCRPC patients. The interviews evaluated the relevance and saliency of the attributes from all perspectives.…”

“…It has been shown that the majority of men with prostate cancer desired an active or collaborative role in treatment decision-making. 21 Several studies have examined treatment preferences of prostate cancer patients and caregivers, [22][23][24][25][26][27] but they were not specific to the new nmCRPC treatment landscape. There remains a need to understand the importance that nmCRPC patients and caregivers attribute to avoiding AEs unique to the new SGARI therapies, and how these AEs may influence their treatment choices in a disease state that is asymptomatic.…”

Impact of access to novel therapies on the initial management of castrate‐resistant prostate cancer: an Australian multicentre study

“…Nevertheless, with growing interest in patient-reported outcomes and quality of life measures, it is expected that deferred treatment (including use of first-generation antiandrogens) will always have a role in clinical practice, particularly as we learn more about the medium-to long-term toxicities related to using these agents and place greater emphasis on understanding the motivations that drive patient treatment preferences. 36 Our study had several potential limitations. First, the retrospective nature of the study is likely to result in selection bias, which may affect the outcome and interpretation of results.…”

“…Whether instituting management decisions based on these newer imaging modalities improves patient outcomes remains unknown. Nevertheless, with growing interest in patient‐reported outcomes and quality of life measures, it is expected that deferred treatment (including use of first‐generation antiandrogens) will always have a role in clinical practice, particularly as we learn more about the medium‐ to long‐term toxicities related to using these agents and place greater emphasis on understanding the motivations that drive patient treatment preferences …”

Custo de tratamento do câncer de próstata resistente à castração por meio da aplicação da técnica Delphi no Sistema de Saúde Suplementar brasileiro

“…Além disso, mais do que uma questão de custos, a fase metastática está associada ao aparecimento de novos sintomas, que são mais agressivos e pioram a qualidade de vida do paciente, ocasionando impacto não só físico, mas também emocional. A progressão da doença é uma preocupação constante na vida do paciente que chega ao estágio metastático, uma vez que é muito rara a possibilidade de cura (NCCN, 2018;Eliasson et al, 2017;Herr & O'Sullivan, 2000). Logo, são importantes tratamentos adequados para que se tente evitar ou prorrogar o tempo até a metástase, auxiliando não só do ponto de vista econômico, mas principalmente relativamente ao impacto social e físico no paciente.…”