Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2026

Patient preference for first-line treatment of locally advanced or metastatic urothelial cancer (Ia/mUC) in Australia, South Korea and Taiwan (144741)

Chun-Te Wu 1 2 , Li-Jen Cheng 3 , Kyungah Park 3 , David Nimke 4 , Marie Lou Camara 5 , Seabastian Heidenreich 6 , Anup Das 6 , Nicolas Krucien 6 , Hui Lu 6
  1. School of Medicine, College of Medicine, Chang Gung University, Taoyuan City, Taiwan
  2. Division of Urology, Department of Surgery, Keelung Chang Gung Memorial Hospital, Keelung City, Taiwan
  3. Astellas Pharma Singapore Pte. Ltd, Singapore, Singapore
  4. Astellas Pharma Inc, Northbrook, Illinois, USA
  5. Astellas Pharma Australia Pty Ltd, Macquarie Park, New South Wales, Australia
  6. PPD Evidera Patient-Centered Research, Thermo Fisher Scientific, London, UK

Aims: As novel treatment options continue to reshape the la/mUC landscape, understanding how patients make trade-offs between benefits, risks, and pathway considerations has become increasingly important. Evidence on patient preferences remain limited. This study assessed patients’ preferences and explored how uncertainty regarding subsequent treatment pathways may influence treatment decisions.

Methods: This non-interventional, online survey-based study enrolled adults with la/mUC across Australia, South Korea, and Taiwan via advocacy groups, panels/databases, and social media (February-April 2026). Two discrete choice experiments (DCEs) were conducted: DCE1 evaluated trade-offs between hypothetical first-line treatment profiles characterized by key attributes (efficacy, risks, regimen); DCE2 examined preferences for hypothetical treatment pathways with varying overall survival (OS) and uncertainty regarding maintenance treatment eligibility. A mixed logit model was used to jointly analyze DCE1 and DCE2. Relative attribute importance (RAI), reflecting the maximum contribution of each attribute relative to treatment choices, and patient’s benefit-risk trade-offs were calculated.

Results: The survey was completed by 167 patients (mean age, 65.4 [range: 30.0-85.0] years; 74.3% male). All attributes significantly influenced treatment preferences: based on RAI, OS was the strongest driver (48.1%), followed by mild/moderate peripheral neuropathy (PN) risk (17.2%), overall response rate (9.5%), severe adverse events (AEs) leading to discontinuation (9.4%), mild/moderate neutropenia (8.8%), and treatment frequency (7.0%). Efficacy attributes contributed up to 57.6% to treatment preference. For a 1-month OS improvement, patients indicated a willingness to accept increases of up to 4.3%, 5.1%, and 7.3% in the risks of severe AEs leading to discontinuation, mild/moderate PN, and mild/moderate neutropenia, respectively. Uncertainty regarding eligibility for subsequent maintenance treatment negatively influenced patient preferences.

Conclusion: Patients with la/mUC prioritized OS and were willing to accept higher AE risks for incremental OS gains across study scenarios. Benefits associated with a clear treatment pathway were valued more highly than those dependent on potentially unavailable subsequent maintenance therapy.