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Effect of neoadjuvant chemotherapy (NAC) on patient preferences for adjuvant treatment in muscle-invasive urothelial carcinoma (MIUC): A multi-country discrete choice experiment (DCE).

Publication ,  Conference
Broughton, EI; Steinberg, GD; Harrison, MR; Braverman, J; Jaffe, DH; Will, O; Senglaub, SS; King-Concialdi, K; Beusterien, K
Published in: Journal of Clinical Oncology
February 20, 2022

454 Background: Patient preference is an important factor in selecting appropriate treatment choices. Although underutilized, the standard of care for MIUC is with NAC, whereas evidence for adjuvant therapy is less clear. With the introduction of novel adjuvant treatments such as immune checkpoint inhibitors, treatment options are expected to expand. This study examines whether preferences for adjuvant therapy is impacted in MIUC patients receiving NAC. Methods: A cross-sectional, web-based survey included patients ≥ 18 years old who self-reported being diagnosed with MIUC and underwent radical cystectomy or nephroureterectomy without recurrence. Patients were recruited from the US, UK, Canada, France, and Germany (May–Sep 2021). A DCE using 2 adjuvant treatment profiles included 8 attributes: cancer-free survival, overall survival (OS), hypothyroidism requiring life-long hormone therapy, risk of a serious adverse event (requiring medical intervention/possible hospitalization), nausea, fatigue, diarrhea, and a dosing regimen (frequency of treatment and monitoring); an opt-out option of no treatment was also shown. Patients were grouped according to self-reported receipt of NAC. Descriptive statistics and hierarchical Bayesian logistic model with estimated preference weights were used. Relative importance estimates (mean ± standard error), or how much the attribute ranges accounted for the variation in preferences, were computed for each attribute. Bivariate comparisons used t-tests. Results: This interim analysis identified 205 patients (70.7% of target sample; US, n = 99; Germany, n = 60; UK, n = 31; Canada, n = 14; France, n = 1). Of 82 patients (40.0%) receiving NAC, 32.7% were patients > 65 years and 55.1% were male; receipt of NAC did not differ by age ( P = 0.248) or sex ( P = 0.731). Patients were willing to accept increased risk in toxicities for increased treatment efficacy. Specifically, mean relative importance of treatment attributes showed that difference in median OS (25 months compared to 78 months) was most important (34.6% ± 1.6), although less so for those who did not receive NAC (30.2% ± 2.4 vs 37.5% ± 2.0; P = 0.022). Patients chose an adjuvant treatment option over ‘no treatment’ 91% of the time, with similar findings by NAC status. Conclusions: Preliminary data indicates that receipt of NAC impacts preferences for adjuvant treatment attributes. However, regardless of these attributes, patients still preferred adjuvant treatment over none. These results suggest that providing standard of care NAC does not reduce patient preference for adjuvant therapy; rather, patient preferences for adjuvant treatment attributes vary by treatment history, with implications for improving quality of care and outcomes.

Duke Scholars

Published In

Journal of Clinical Oncology

DOI

EISSN

1527-7755

ISSN

0732-183X

Publication Date

February 20, 2022

Volume

40

Issue

6_suppl

Start / End Page

454 / 454

Publisher

American Society of Clinical Oncology (ASCO)

Related Subject Headings

  • Oncology & Carcinogenesis
  • 3211 Oncology and carcinogenesis
  • 1112 Oncology and Carcinogenesis
  • 1103 Clinical Sciences
 

Citation

APA
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ICMJE
MLA
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Broughton, E. I., Steinberg, G. D., Harrison, M. R., Braverman, J., Jaffe, D. H., Will, O., … Beusterien, K. (2022). Effect of neoadjuvant chemotherapy (NAC) on patient preferences for adjuvant treatment in muscle-invasive urothelial carcinoma (MIUC): A multi-country discrete choice experiment (DCE). In Journal of Clinical Oncology (Vol. 40, pp. 454–454). American Society of Clinical Oncology (ASCO). https://doi.org/10.1200/jco.2022.40.6_suppl.454
Broughton, Edward I., Gary D. Steinberg, Michael Roger Harrison, Julia Braverman, Dena H. Jaffe, Oliver Will, Steven S. Senglaub, Kristen King-Concialdi, and Kathleen Beusterien. “Effect of neoadjuvant chemotherapy (NAC) on patient preferences for adjuvant treatment in muscle-invasive urothelial carcinoma (MIUC): A multi-country discrete choice experiment (DCE).” In Journal of Clinical Oncology, 40:454–454. American Society of Clinical Oncology (ASCO), 2022. https://doi.org/10.1200/jco.2022.40.6_suppl.454.
Broughton EI, Steinberg GD, Harrison MR, Braverman J, Jaffe DH, Will O, et al. Effect of neoadjuvant chemotherapy (NAC) on patient preferences for adjuvant treatment in muscle-invasive urothelial carcinoma (MIUC): A multi-country discrete choice experiment (DCE). In: Journal of Clinical Oncology. American Society of Clinical Oncology (ASCO); 2022. p. 454–454.
Broughton, Edward I., et al. “Effect of neoadjuvant chemotherapy (NAC) on patient preferences for adjuvant treatment in muscle-invasive urothelial carcinoma (MIUC): A multi-country discrete choice experiment (DCE).Journal of Clinical Oncology, vol. 40, no. 6_suppl, American Society of Clinical Oncology (ASCO), 2022, pp. 454–454. Crossref, doi:10.1200/jco.2022.40.6_suppl.454.
Broughton EI, Steinberg GD, Harrison MR, Braverman J, Jaffe DH, Will O, Senglaub SS, King-Concialdi K, Beusterien K. Effect of neoadjuvant chemotherapy (NAC) on patient preferences for adjuvant treatment in muscle-invasive urothelial carcinoma (MIUC): A multi-country discrete choice experiment (DCE). Journal of Clinical Oncology. American Society of Clinical Oncology (ASCO); 2022. p. 454–454.

Published In

Journal of Clinical Oncology

DOI

EISSN

1527-7755

ISSN

0732-183X

Publication Date

February 20, 2022

Volume

40

Issue

6_suppl

Start / End Page

454 / 454

Publisher

American Society of Clinical Oncology (ASCO)

Related Subject Headings

  • Oncology & Carcinogenesis
  • 3211 Oncology and carcinogenesis
  • 1112 Oncology and Carcinogenesis
  • 1103 Clinical Sciences