Stated Preferences for Systemic Treatments for Prostate Cancer: A Targeted Review of the Discrete-Choice Experiment Literature

Advances in prostate cancer (PC) therapy have improved survival and expanded systemic treatment options. To support treatment decision-making, it is important to understand tradeoffs patients are willing to make between survival and other factors such as side effects. This targeted literature review evaluated the results of discrete-choice experiment (DCE) studies assessing patients’ and healthcare professionals’ (HCPs’) preferences for systemic therapies for PC. PubMed was searched for PC DCE studies evaluating patient or HCP preferences for systemic treatment published through April 2025. Attribute importance rankings were summarized descriptively and stratified by respondent type and by PC stage corresponding to the treatments assessed. Studies primarily assessing preferences for androgen deprivation therapy, which is used in patients with biochemically recurrent non-metastatic castration-sensitive PC, were categorized as “earlier stage”; those assessing systemic combination therapies for metastatic or castration-resistant PC were categorized as “late stage.” Seventeen eligible studies were included (late-stage PC treatments, n = 10 patient studies and n = 3 HCP studies; earlier-stage PC treatments, n = 4 patient studies, with one reporting an HCP subgroup). Overall, patients and HCPs showed the strongest preferences for attributes related to efficacy outcomes (e.g., extending overall survival, clinical progression). Preferences for avoidance of long-term safety attributes, such cardiovascular side effects, were generally ranked higher in late-stage studies than in earlier-stage studies. Meanwhile, avoidance of short-term tolerability attributes, such as injection-site reaction and sexual function, were prioritized and measured only in earlier-stage studies. Preferences differed between respondent types for late-stage treatments, with HCPs placing greater importance on tolerability attributes (fatigue, central nervous system side effects) and patients prioritizing safety (avoiding falls, cardiovascular side effects). Despite differences in safety and tolerability attribute rankings among respondents across earlier-stage and late-stage PC treatments, efficacy outcomes were most important to patients and HCPs.