Stated Preferences for Systemic Treatments for Prostate Cancer: A Targeted Review of the Discrete-Choice Experiment Literature.
Neeraj Agarwal, Brett Hauber, Agnes Hong et al.
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In 30 seconds
This targeted review summarized discrete-choice experiment studies of patient and healthcare professional preferences for systemic prostate cancer treatments. PubMed studies published through April 2025 were identified, and attribute rankings were described by respondent type and treatment stage. Seventeen studies were included: 14 patient studies and four with healthcare professional data, including one patient study with an HCP subgroup. Across treatment stages and respondent groups, efficacy outcomes—such as overall survival and clinical progression—were the most important attributes. Safety and tolerability priorities varied by stage and respondent type.
Key findings
- Seventeen eligible studies were included: 10 late-stage patient studies, three late-stage HCP studies, and four earlier-stage patient studies, one with an HCP subgroup.
- Patients and HCPs most strongly prioritized efficacy attributes, including extending overall survival and delaying clinical progression.
- Avoidance of long-term safety risks, including cardiovascular side effects, generally ranked higher in late-stage than earlier-stage studies.
- For late-stage treatments, HCPs emphasized fatigue and central nervous system side effects, while patients prioritized avoiding falls and cardiovascular side effects.
Why it matters
These preference studies show that treatment tradeoffs are not captured by efficacy alone: patients and clinicians may weigh safety and tolerability differently, and priorities can vary with treatment stage. Understanding these patterns can inform discussions about treatment attributes and help frame decisions around outcomes that matter to patients, while recognizing that stated preferences do not establish the effects of treatment choices.
What to keep in mind
The review summarized attribute rankings descriptively across a limited set of DCE studies; findings may depend on the attributes and treatment contexts assessed.