MP28-19 PATIENT PERCEPTIONS OF ADJUVANT THERAPY IN RENAL CELL CARCINOMA

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP28-19 PATIENT PERCEPTIONS OF ADJUVANT THERAPY IN RENAL CELL CARCINOMA Michael Staehler, Severin Rodler, Ulka Vaishampayan, Mark Ball, Ithaar Derweesh, Pavlos Msaouel, and Dena Battle Michael StaehlerMichael Staehler More articles by this author , Severin RodlerSeverin Rodler More articles by this author , Ulka VaishampayanUlka Vaishampayan More articles by this author , Mark BallMark Ball More articles by this author , Ithaar DerweeshIthaar Derweesh More articles by this author , Pavlos MsaouelPavlos Msaouel More articles by this author , and Dena BattleDena Battle More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003256.19AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Adjuvant pembrolizumab is currently considered the standard of care for patients with high-risk localized renal cell carcinoma (RCC). However, since approval, multiple trials testing checkpoint inhibitors in the adjuvant setting have failed to meet their primary endpoints, casting doubt on the oncological benefit of therapies that carry the risk of life-long toxicity. We sought to assess how patients perceive the benefits and risks of adjuvant therapy. METHODS: The survey was developed by the Kidney Cancer Research Alliance (KCCure), with multidisciplinary representation from urologic surgeons, medical oncologists and patient advocates. The survey was broadcast between 07/2022 and 09/2022 to patients via website, mailing lists and social media platforms. Multiple responses from the same patient were prohibited via anonymized IP address tracking. Out of 1,062 participants 639 patients self-identified with localized RCC and 223 patients had stage III RCC at initial diagnosis. RESULTS: Median age was 57 years (24-86). 113 patients were offered adjuvant therapy by their doctor, 74 patients were on or had adjuvant therapy (18% TKI, 82% IO). Patients with stage 3 disease assessed their average personal risk of recurrence to be 47% - 10% higher than what they reported their doctor assessed risk to be (37%). The most important factors related to adjuvant decision making, were Risk of Dying from Cancer (76%), severity of possible side effects (43%), chance of having side effects (35%), time required for treatment (24%), cost of treatment (7%). 49% of patients believe that treatment reduces the risk of recurrent disease by more than 30% and 25% believe it reduces risk by more than 50%. Adjuvant therapy was completed by 46%, 17% stopped early due to side effects and 14% recurred while on therapy. Side effects were asymptomatic or mild in 38%, moderate without invasive intervention or hospitalization in 48%, severe, requiring hospitalization in 8% and life-threatening in 7%. 18% of patients were told that their side effects would be life-long. CONCLUSIONS: Patients with high-risk localized disease estimate their risk significantly higher than what their doctors assess their risk to be. Thus, weighing decisions about adjuvant therapy, patients rank risk of dying from cancer over the risk of developing side effects and the severity of side effects. One quarter of patients believe that adjuvant therapy will reduce their risk of recurrence by 50 percent or more. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e378 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Michael Staehler More articles by this author Severin Rodler More articles by this author Ulka Vaishampayan More articles by this author Mark Ball More articles by this author Ithaar Derweesh More articles by this author Pavlos Msaouel More articles by this author Dena Battle More articles by this author Expand All Advertisement PDF downloadLoading ...