PATIENT PREFERENCES FOR THE TREATMENT OF BCG-UNRESPONSIVE NON-MUSCLE-INVASIVE BLADDER CANCER (NMIBC): FINDINGS FROM A UNITED KINGDOM (UK) QUESTIONNAIRE
Author(s)
Melanie Costin, BS1, Thomas Snell, MSc2, Joanne Noble-Longster, BSc, MSc, PhD2, Elise Gamertsfelder, MSc3, Juergen Reiher, MSc4, SCOTT C. FLANDERS, BS, MHA, PhD5, Bruce Brown, MD5, Paramananthan Mariappan, PhD6, Alison Birtle, MRCP, FRCR, MD7;
1Fight Bladder Cancer, Oxfordshire, United Kingdom, 2Tolley Health Economics, Buxton, United Kingdom, 3Eric Low Consulting Ltd, London, United Kingdom, 4SolemEU GmbH, Munster, Germany, 5ImmunityBio, Inc., San Diego, CA, USA, 6Edinburgh University, Edinburgh, United Kingdom, 7Lancashire Teaching Hospitals NHS Foundation Trust, Preston, United Kingdom
1Fight Bladder Cancer, Oxfordshire, United Kingdom, 2Tolley Health Economics, Buxton, United Kingdom, 3Eric Low Consulting Ltd, London, United Kingdom, 4SolemEU GmbH, Munster, Germany, 5ImmunityBio, Inc., San Diego, CA, USA, 6Edinburgh University, Edinburgh, United Kingdom, 7Lancashire Teaching Hospitals NHS Foundation Trust, Preston, United Kingdom
OBJECTIVES: In the United Kingdom (UK), adults with Bacillus Calmette-Guérin (BCG)‑unresponsive high-risk non‑muscle‑invasive bladder cancer (NMIBC) are offered radical cystectomy (RC) or various bladder‑sparing therapies (BSTs). Limited contemporary evidence exists on how patients weigh these options. This study aimed to (1) assess preferences for BSTs versus RC after BCG, and (2) identify factors influencing patient decision‑making.
METHODS: An online questionnaire was distributed via the patient‑advocacy group Fight Bladder Cancer to UK NMIBC patients who were currently receiving or had previously received BCG. The survey collected demographics, treatment priorities, and preferences using multiple‑choice and free‑text items. Descriptive statistics summarize responses; subgroup analyses explore differences by age, gender, and treatment status.
RESULTS: Eighty‑six patients completed the questionnaire (30% currently on BCG, 70% post‑BCG). The cohort was 54% female, despite lower bladder cancer prevalence. BCG discontinuation occurred because of planned completion (42%), disease progression/recurrence (33%), toxicity (22%), and supply shortages (3%). After BCG, 17% received intravesical hyperthermic mitomycin C (hMMC) and 32% underwent RC (including four who had hMMC). Nearly half of the respondents stated they would choose RC after BCG; however, 27% of patients preferred BST. Preference for BST was highest among participants still receiving BCG, whereas those who had already undergone RC showed a stronger preference towards repeating their decision to have RC. Older participants were less likely to favor RC. Clinical effectiveness - impact on disease recurrence, progression, and life expectancy - was rated “extremely important” by most respondents. Procedural considerations and daily‑life impact varied, with male participants expressing greater concern about lifestyle disruption from RC.
CONCLUSIONS: UK NMIBC patients exhibit diverse treatment preferences after intravesical BCG treatment failures. Preferences are shaped by current and past treatment experience, age, and personal values. Incorporating these patient‑centered insights into shared‑decision discussions may support more individualized, preference‑aligned management of BCG‑unresponsive NMIBC.
METHODS: An online questionnaire was distributed via the patient‑advocacy group Fight Bladder Cancer to UK NMIBC patients who were currently receiving or had previously received BCG. The survey collected demographics, treatment priorities, and preferences using multiple‑choice and free‑text items. Descriptive statistics summarize responses; subgroup analyses explore differences by age, gender, and treatment status.
RESULTS: Eighty‑six patients completed the questionnaire (30% currently on BCG, 70% post‑BCG). The cohort was 54% female, despite lower bladder cancer prevalence. BCG discontinuation occurred because of planned completion (42%), disease progression/recurrence (33%), toxicity (22%), and supply shortages (3%). After BCG, 17% received intravesical hyperthermic mitomycin C (hMMC) and 32% underwent RC (including four who had hMMC). Nearly half of the respondents stated they would choose RC after BCG; however, 27% of patients preferred BST. Preference for BST was highest among participants still receiving BCG, whereas those who had already undergone RC showed a stronger preference towards repeating their decision to have RC. Older participants were less likely to favor RC. Clinical effectiveness - impact on disease recurrence, progression, and life expectancy - was rated “extremely important” by most respondents. Procedural considerations and daily‑life impact varied, with male participants expressing greater concern about lifestyle disruption from RC.
CONCLUSIONS: UK NMIBC patients exhibit diverse treatment preferences after intravesical BCG treatment failures. Preferences are shaped by current and past treatment experience, age, and personal values. Incorporating these patient‑centered insights into shared‑decision discussions may support more individualized, preference‑aligned management of BCG‑unresponsive NMIBC.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
P63
Topic
Patient-Centered Research
Disease
SDC: Oncology