Srinivas S, Mansfield CA, Sandin R, Hauber AB, Hariharan S, Matczak EM, Pugh AL, Chen C. Exploring the effect of medication features in renal cell carcinoma: a patient preference study. Poster presented at the 2015 Genitourinary Cancers Symposium; February 2015.

Background: Limited information exists about patient preference (PP) for renal cell carcinoma (RCC) medication profiles, especially related to uncertainty in outcomes, potential correlation between toxicity and efficacy, and dosing schedules.

Methods: RCC patients in the United States and Canada completed an online survey with questions that examined PP for medication profiles by varying efficacy (progression free survival [PFS]), tolerability (fatigue, hand-foot syndrome, hypertension, diarrhea) and dosing schedules (with or without 2 week break). A discrete-choice experiment (DCE) survey tested the impact of information on correlation between PFS and toxicity on medication choice, with half of the sample randomly assigned to receive the information. Separate exploratory questions assessed patient tradeoff between higher toxicity during treatment vs. the chance of longer PFS (2+ years) and type of dosing schedules, respectively.

Results: The interim survey results included 343 RCC patients (172 metastatic (mRCC), 96 currently on treatment). In the exploratory questions, 50% of mRCC patients and 51% of patients receiving treatment selected the option with higher toxicity and a 5% higher chance of longer PFS. Patients who received information on a potential correlation between tolerability and PFS were more likely to say they would tolerate worse toxicity for a 5% higher chance of longer PFS than those who did not receive the information (49% vs. 31%). A majority of RCC patients preferred a treatment with a 2-week break in the dosing schedule compared to continuous treatment (59% vs. 25%). When told side effects were worse during the treatment period for the medication with the break vs. the continuous treatment (moderate vs. mild), 42% of RCC patient, 50% of mRCC patients, and 55% patients on treatment still preferred a break. Additional DCE analysis is underway and will provide more results on patient preferences for medication profiles, including the importance of information received.

Conclusions: Patients have heterogeneous preferences over medicine features and outcomes. Physicians need to provide patients with comprehensive information about medication features and efficacy to provide a personalized and optimal approach to treatment.