Understanding Patient and Oncologist Preferences in the Management of Metastatic Renal Cell Carcinoma

Treatment of metastatic renal cell carcinoma (mRCC) has expanded with development of combination therapies containing tyrosine kinase inhibitors (TKIs) with immune checkpoint inhibitors (ICI) agents or dual ICI agents. However, patient preferences may not necessarily be incorporated into management decisions. We aimed to understand patient preferences in the management of mRCC and compare it with oncologists' perspectives.

A single-arm, prospective study surveyed patients with mRCC utilizing a questionnaire containing descriptions of 5 treatment options in simple language. Patients rated their preference for each option on a scale from 1 (least preferred) to 10 (most preferred). The same questionnaire plus basic de-identified patients' characteristics were provided to 2 academic oncologists and 1 community oncologist.

A total of 54 patients were surveyed. The most preferred patient treatment option was TKI with mean score of 7.9 while the least popular was early phase clinical trials (CTs) with a mean score of 5.9 (p < 0.01). Patient's employment status, speaking language, and denovo metastatic disease were the variables found to be associated with likelihood of picking a particular treatment option. Among oncologists, the most selected treatment options were enrollment in early and late phase CTs with mean scores of 7.61 and 7.52 respectively and single-agent TKI was least preferred with a mean score of 5.69 (p < 0.01). Age and performance status influenced oncologist therapy choices based on the multivariable analysis.

This study unveils differences between patients and oncologists' treatment preferences for mRCC and underscores the importance of individualized discussion with each patient to evaluate his or her therapeutic objectives.