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Physician preferences for non-metastatic castration-resistant prostate cancer treatment

BMC Urology Jul 05, 2020

Srinivas S, Mohamed AF, Appukkuttan S, et al. - For the treatment of non-metastatic castration-resistant prostate cancer (nmCRPC), second-generation androgen receptor inhibitors (SGARIs) have been recently approved and are noted to have similar efficacy but with differences in safety profiles. Via performing a discrete choice experiment, researchers here investigated the basis on which United States physicians make treatment decisions between adverse events (AEs) and survival gains in nmCRPC, a largely asymptomatic disease. Data were obtained via an online survey completed by 149 treating physicians; the survey included 14 treatment choice questions, each comparing 2 hypothetical treatment profiles, which differed in terms of 5 safety and 2 efficacy attributes. More importance was given by physicians on survival than on time to pain progression; per them, the most important safety attributes were a reduction in cognitive problems from severe to none, a reduction in risk of a serious fracture from 8% to none, and a reduction in fatigue from severe to none. Physicians were willing to trade substantial amounts of survival to avoid AEs between hypothetical treatments. Findings indicates the significance of carefully balancing therapies’ benefits and risks to finally optimize the overall quality of nmCRPC patients’ survival. Nonetheless, it is noted that the results from the included physicians may not represent the viewpoints of all nmCRPC-treating physicians.

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