67P Factors that may influence physicians’ perceptions of “cure” in ovarian cancer: A discrete choice experiment

Novel therapies increase optimism for a cure for ovarian cancer (OC). Yet, physicians remain reticent towards discussing "cure" as a treatment outcome and the factors associated with physicians' perceptions of "cure" in OC are poorly understood. We evaluated the influence of patient characteristics, including treatment outcomes, on oncologists' perceptions of better prognosis and "cure" in OC. US oncologists (N=150) completed a cross-sectional survey in spring 2023 which included a discrete choice experiment (DCE) that iteratively presented 2 hypothetical patient profiles varying on 8 attributes (Table). Physicians select the profile they associated with a better prognosis. Attribute-level preference weights were estimated with hierarchical Bayesian models; a larger absolute difference between the most- and least preferred attribute levels indicated greater influence on preferences. Differences in relative attribute importance (RI) estimates were evaluated by practice setting, specialty and 12-month OC case volume. Factors that most influenced optimism for better prognosis were: increasing patients' progression-free years from 2 to 10 (RI=22.0%), reducing cancer stage from IV to II (RI=20.0%), and changing CA125 from rising to low/normal (RI=17.7%). Younger age was more important to academic versus community oncologists (p<0.01) and to oncologists with >50 epithelial OC cases in the past 12 months (p<0.01). The absence of ascites influenced gynecological oncologists' likelihood of giving a better prognosis than medical/hematological oncologists (p=0.02).Table: 67PAttributes, levels & preference weights from the DCEAttributeLevelPreference WeightPatient age (years)45 60 750.45 0.09 -0.54Received anti-vascular endothelial growth factor-(VEGF) therapy in first lineYes No-0.03 0.03Cancer stageII III IV1.5 -0.11 -1.39BReast CAncer gene (BRCA)/Homologous Recombination Deficiency (HRD) statusBRCA wild type/HRD-test (-) BRCA wild type/HRD-test (+) BRCA mutation-0.08 -0.44 0.52CytoreductionComplete gross resection ≤ 1cm residual tumor >1cm residual tumor0.22 0.17 -0.4Ascites presentYes No-0.57 0.57Progression free years2 5 10-1.7 -0.03 1.73Cancer antigen (CA)125 statusLow/normal Rising1.41-1.41 Open table in a new tab Oncologists' perceptions of better prognosis and potential for cure in OC may be influenced by several patient and treatment outcomes, such as longer PFS, lower stage, and CA125 status. Use of therapies that improve factors linked to better prognosis may increase oncologists' willingness to discuss "cure" with OC patients.