IP5-MATTER
Research type
Research Study
Full title
Patients’ preferences in the treatment of hormone-sensitive metastatic prostate cancer: a discrete choice experiment
IRAS ID
276834
Contact name
Hashim Uddin Ahmed
Contact email
Sponsor organisation
Imperial Joint Research Compliance Office
Duration of Study in the UK
1 years, 3 months, 1 days
Research summary
Research Summary
Key Question – What?
The main aim of MATTER is to understand what types of treatment men who have been newly-diagnosed with metastatic prostate cancer (mPCa) might prefer. We also want to look at their willingness to accept new treatments that might improve survival but have potential risk of side-effects and worsening quality-of-life. We will do this using a study that looks at trade-offs between the different characteristics of different treatments.
Key Question – Why?
In the UK, over 14,000 men each year are diagnosed with prostate cancer that has spread beyond the prostate gland. We have improved life expectancy in these men using medication such as new hormone drugs and chemotherapy.
Recently, it has been proposed that by treating the main cancer in the prostate and some areas that have spread might improve survival further. This is because the amount of cancer cells in the body is reduced and the signals that encourage more cancer growth can be interrupted.
‘Local’ treatment to the prostate can be given using surgical approaches or radiotherapy. Treatment to areas of spread is given using radiotherapy. These approaches are being tested in trials. More intensive treatments such as these might further improve survival but can carry additional risks of complications and long-term side effects.
It is important to know to what extent men will accept these new approaches and whether when choosing, they make trade-offs between the problems caused by treatments and the benefit they give.
Key Question – How?
We have previously carried out a study called a ‘discrete choice experiment’ (DCE) in men with cancer that has not spread. This showed men are willing to make trade-offs between survival and side-effects.
A DCE relies on the fact that patients make complex decisions when faced with a number of options for treatment. Hypothetical treatment scenarios are put to real patients to allow researchers to find out to which factors or ‘attributes’ involved in treatment men value most and which will they ‘trade-off’.
e.g a man might be offered surgical removal of his prostate with the potential of 12 months of added life. However, due to the surgery he may suffer urinary incontinence. Whilst this may also occur as a result of his cancer at some stage, by choosing surgery he risks bringing this symptom forward. Therefore, he may decide to have targeted surgery e.g. freezing which has fewer side-effects. A DCE helps understand the trade-offs men make.
Using interviews, with 10 men, we will first establish what are the key attributes (e.g. loss of libido, incontinence, pain) associated with treatment. Next we will develop the series of hypothetical scenarios that we can present 300 men across the UK.
Men will be asked to choose the treatment they most prefer using the scenarios. The scenarios will be chosen to balance the information needed for statistical analysis and the burden on men. The statistical analysis of men’s choices will allow us to assign a mathematical value to the importance of each attribute and calculate the trade-offs between the attributes. This will allow us to make an overall statement on which attributes are the most important factors to men with mPCa when choosing which form of treatment to consent to.
Summary of Results
We performed a large study to ascertain how patients diagnosed with advanced (metastatic) prostate cancer at their first diagnosis made decisions regarding additional available treatments for their prostate and cancer deposits (metastases). Treatments would not provide cure but may reduce cancer burden (cytoreduction), prolong life, and extend time without cancer progression. We reported that most patients were willing to accept additional treatments for survival benefits, in particular treatments that preserved urinary function and reduced fatigue.
REC name
East of England - Cambridgeshire and Hertfordshire Research Ethics Committee
REC reference
20/EE/0194
Date of REC Opinion
5 Oct 2020
REC opinion
Further Information Favourable Opinion