PMID- 32571276
OWN - NLM
STAT- MEDLINE
DCOM- 20210318
LR  - 20240329
IS  - 1471-2490 (Electronic)
IS  - 1471-2490 (Linking)
VI  - 20
IP  - 1
DP  - 2020 Jun 22
TI  - Physician preferences for non-metastatic castration-resistant prostate cancer 
      treatment.
PG  - 73
LID - 10.1186/s12894-020-00631-4 [doi]
LID - 73
AB  - BACKGROUND: Recent approvals of second-generation androgen receptor inhibitors 
      (SGARIs) have changed the treatment landscape for non-metastatic 
      castration-resistant prostate cancer (nmCRPC). These SGARIs have similar efficacy 
      but differ in safety profiles. We used a discrete choice experiment to explore 
      how United States physicians make treatment decisions between adverse 
      events (AEs) and survival gains in nmCRPC, a largely asymptomatic disease. 
      METHODS: Treating physicians (n = 149) participated in an online survey that 
      included 14 treatment choice questions, each comparing 2 hypothetical treatment 
      profiles, which varied in terms of 5 safety and 2 efficacy attributes. We 
      described safety attributes (fatigue, skin rash, cognitive problems, falls, and 
      fractures) in terms of severity and frequency, and efficacy attributes (overall 
      survival [OS] and time to pain progression) in terms of duration of effect. We 
      used a random parameters logit model to estimate preference weights and 
      importance scores for each attribute. We also estimated the amount of survival 
      gain physicians were willing to trade for a reduction in specific AEs between 
      treatment options. RESULTS: Physicians placed more importance on survival than on 
      time to pain progression, and viewed 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 as the most important safety attributes. 
      Physicians were willing to forego 9.1 and 6.6 months of OS, respectively, to 
      reduce cognitive problems and fatigue from severe to mild-to-moderate. To reduce 
      the risk of a serious fracture from 8 to 5% and 5% to none, physicians were 
      willing to trade 3.9 and 5.3 months of OS, respectively. CONCLUSIONS: Physicians 
      were willing to trade substantial amounts of survival to avoid AEs between 
      hypothetical treatments. These results emphasize the importance of carefully 
      balancing therapies' benefits and risks to ultimately optimize the overall 
      quality of nmCRPC patients' survival. Nonetheless, it is noted that the results 
      from the study sample of 149 physicans may not be representative of the 
      viewpoints of all nmCRPC-treating physicians.
FAU - Srinivas, Sandy
AU  - Srinivas S
AD  - Stanford University Medical Center, Palo Alto, California, USA. 
      sandysri@stanford.edu.
FAU - Mohamed, Ateesha F
AU  - Mohamed AF
AD  - Bayer U.S. LLC, Whippany, NJ, USA.
FAU - Appukkuttan, Sreevalsa
AU  - Appukkuttan S
AD  - Bayer U.S. LLC, Whippany, NJ, USA.
FAU - Botteman, Marc
AU  - Botteman M
AD  - Pharmerit International, Bethesda, MD, USA.
FAU - Ng, Xinyi
AU  - Ng X
AD  - Pharmerit International, Bethesda, MD, USA.
FAU - Joshi, Namita
AU  - Joshi N
AD  - Pharmerit International, Bethesda, MD, USA.
FAU - Horodniceanu, Erica
AU  - Horodniceanu E
AD  - Pharmerit International, Bethesda, MD, USA.
FAU - Waldeck, A Reginald
AU  - Waldeck AR
AD  - Bayer U.S. LLC, Whippany, NJ, USA.
FAU - Simmons, Stacey J
AU  - Simmons SJ
AD  - Bayer U.S. LLC, Whippany, NJ, USA.
LA  - eng
GR  - NA/Bayer US LLC/
PT  - Journal Article
DEP - 20200622
PL  - England
TA  - BMC Urol
JT  - BMC urology
JID - 100968571
RN  - 0 (Androgen Receptor Antagonists)
SB  - IM
MH  - Androgen Receptor Antagonists/*therapeutic use
MH  - *Attitude of Health Personnel
MH  - Humans
MH  - Male
MH  - *Practice Patterns, Physicians'
MH  - Prostatic Neoplasms, Castration-Resistant/*drug therapy/mortality
MH  - Survival Rate
MH  - *Urology
PMC - PMC7310549
OTO - NOTNLM
OT  - Castration-resistant
OT  - Choice behavior
OT  - Physicians
OT  - Prostatic neoplasms
OT  - Risk assessment
COIS- This study was funded by Bayer US LLC. SSrinivas consulted for Bayer US LLC and 
      Janssen, and have received research funding from Bayer and Pfizer. AFM and ARW 
      are full-time employees of Bayer US LLC and own stocks in Bayer. S Simmons is a 
      full-time employee of Bayer US LLC and own stocks in Bayer and Pfizer. SA is a 
      full-time employee of Bayer US LLC. MB is a shareholder of Pharmerit 
      International, the institution which received funding from Bayer US LLC, for 
      conducting the study. MB, XN, NJ and EH are full-time employees of Pharmerit 
      International, the institution which received funding from Bayer US LLC, for 
      conducting the study.
EDAT- 2020/06/24 06:00
MHDA- 2021/03/19 06:00
PMCR- 2020/06/22
CRDT- 2020/06/24 06:00
PHST- 2019/10/04 00:00 [received]
PHST- 2020/05/20 00:00 [accepted]
PHST- 2020/06/24 06:00 [entrez]
PHST- 2020/06/24 06:00 [pubmed]
PHST- 2021/03/19 06:00 [medline]
PHST- 2020/06/22 00:00 [pmc-release]
AID - 10.1186/s12894-020-00631-4 [pii]
AID - 631 [pii]
AID - 10.1186/s12894-020-00631-4 [doi]
PST - epublish
SO  - BMC Urol. 2020 Jun 22;20(1):73. doi: 10.1186/s12894-020-00631-4.