There have been major advances in the systemic treatment of renal cell cancer over the past decade, with many targeted therapies being shown to be of benefit in the metastatic, but not yet adjuvant, setting. Targeted therapies (eg sorafenib) have a different toxicity profile to other classes of anti-cancer drugs (eg more frequent rashes, hand-foot syndrome, diarrhoea) and doctors often consider them to be more tolerable treatments. However, patients’ views about the relative benefits and harms of targeted therapies are largely unknown.
Preference studies determine the survival benefits needed to justify the harms and inconveniences of a treatment. Patients generally judge small survival benefits (eg an extra 1 month life expectancy or 1% survival rate) to make adjuvant chemotherapy worthwhile, and smaller benefits than do doctors. There are few published studies of preferences for targeted therapies, and none in renal cell cancer.
SORCE is an international, phase III, double-blind, placebo-controlled trial which is investigating the efficacy of adjuvant sorafenib in patients with resected primary renal cell carcinoma at high or intermediate risk of relapse. As part of this trial, a sub-study patients’ and doctors’ preferences for adjuvant sorafenib is being conducted in Australia, New Zealand and the United Kingdom. Interim baseline results from this sub-study will be presented at the COSA annual meeting.