(UroToday.com) The 2022 GU ASCO Annual meeting included a prostate cancer session highlighting work from Dr. Robert J. Jones and colleagues presenting results of an international qualitative study assessing preferences and perceptions of patients with mCRPC for treatments and biomarker testing. Despite a range of available treatments, outcomes for mCRPC remains poor with significant morbidity. The PARP inhibitors are targeted therapeutics approved to treat mCRPC patients with genetic mutations in homologous recombination repair (HRR). However, to benefit from PARP inhibitors as a single agent, patients usually need to undergo biomarker testing to determine their mutation status. As an initial step to understand patient preferences for mCRPC treatments, this study investigated the treatment features important to mCRPC patients and their preferences for and perceptions of biomarker testing.
This preliminary qualitative study included 25 men in the US, UK, Germany, Spain, and Japan with self-reported mCRPC diagnosed at least 6 months previously. Participants completed a 60-minute, one-on-one, semi-structured interview online or by telephone about mCRPC treatments, disease impact, and biomarker testing. Data was analyzed using standard qualitative research procedures.
Participants had a mean age of 62 years and were diagnosed with prostate cancer an average of 68 months prior. Approximately half (52%) had metastasized > 1 year prior and more than half (56%) reported no HRR genetic mutation. The most frequently reported symptoms were pain (60%), urinary problems (56%), and fatigue (32%):
Participants stated that pain impacted their sleep, daily activities, and social lives. There were 60% of participants that reported shared treatment decision-making with their physician, some (24%) shared it with partners or caregivers, and others (32%) left treatment decisions up to their physician due to their lack of knowledge. Quality of life (QoL) was the most important treatment benefit reported (56%), followed by progression-free survival (PFS) (52%), overall survival (OS) (48%), and reduced pain (44%):
Some participants reported their desire for prolonged survival needed to be balanced with adequate QoL. Few participants reported reduced fatigue (24%) or urinary problems (12%) as desired treatment benefits.
Overall, 64% had previously undergone biomarker testing to determine mutation status, and 56% of tested participants reported that their physician discussed the purpose and benefits of testing. Based on conversations with their physicians, both tested and untested participants felt that biomarker testing would inform them about heritable risk of mutation and help find new targeted treatments. Untested participants with a negative view of biomarker testing (22%) reported concerns about the need for further invasive biopsies.
Dr. Jones concluded his presentation assessing preferences and perceptions of patients with mCRPC for treatments and biomarker testing with the following take-home points:
- QoL followed by PFS, OS, and reduced pain were the most important benefits of treatment to participants
- More than half of participants had a positive view of biomarker testing, especially if testing could lead to targeted therapies and inform about heritable risk
- These results will inform the design of an international discrete choice study of biomarker testing among men with mCRPC
- A full quantitative study using insights from these qualitative interviews will be conducted with a wider sample of both mCRPC patients and treating clinicians
Presented by: Robert J. Jones, Beatson West of Scotland Cancer Centre, University of Glasgow, Glasgow, United Kingdom
Co-Authors: Hannah Collacott, Alicia K. Morgans, Elena Castro, Stefan Machtens, Hiroji Uemura, Tommi Tervonen, Sameer Ghate, Shan Jiang, Theresa Cain, Nenad Medic, Sarah Payne, Alicia Gayle
Written by: Zachary Klaassen, MD, MSc – Urologic Oncologist, Assistant Professor of Urology, Georgia Cancer Center, Augusta University/Medical College of Georgia, @zklaassen_md on Twitter during the 2022 American Society of Clinical Oncology Genitourinary (ASCO GU) Cancers Symposium, Thursday Feb 17 – Saturday Feb 19, 2022