To investigate treatment preferences of Japanese patients with locally advanced or metastatic urothelial carcinoma (la/mUC).

A discrete-choice experiment survey methodology was used to elicit patient preferences for attributes of la/mUC treatment, including adverse events (nausea/vomiting, neuropathy, alopecia and maculopapular rash), hospital stay requirements for treatment administration and overall survival. A multinomial logistic regression model was used to estimate treatment preferences. Coefficients of the model were then used to calculate the relative importance of each treatment attribute.

Participants were recruited through healthcare facilities with urology departments across Japan.

The study included 109 patients (72.5% male; mean (SD) age, 71.3 (8.9) years). Patients preferred treatments that minimised adverse events that could affect their daily activities, had a more favourable survival profile and did not require hospital stays for administration. Neuropathy emerged as the most important attribute to patients when making treatment decisions (relative attribute importance (RAI), 27.7%), followed by nausea/vomiting (RAI, 27.3%), maculopapular rash (RAI, 16.5%), hospital stay requirements (RAI, 12.1%), alopecia (RAI, 8.2%) and overall survival (RAI, 8.1%). Findings were similar across various subgroup analyses, though patients who were chemotherapy-experienced prioritised avoidance of neuropathy and nausea/vomiting more highly than those who were chemotherapy-naïve.

In this study, Japanese patients with la/mUC were more concerned about reduced quality of life due to adverse events than extending survival by 6 months. Patients, clinicians and other members of the care team need to communicate frequently and candidly about a patient’s well-being.