The top 10 Italian priorities in renal cell carcinoma (RCC): A people-centered approach to cancer care for future research.

Abstract

e16522 Background: The management of RCC has advanced considerably in recent years, highlighting the need for research priorities to integrate clinicians and patient-centered perspectives. Increasingly, people with cancer are recognized as leading role in the decision-making process of the treatment pathways. In this context, our project sponsored a consensus-based priority-setting partnership between Italian people with RCC and oncologists, to identify the top 10 Italian priorities in RCC. Methods: The study consisted of three steps. In Step I (Aug-Oct 2024), two tailored surveys were distributed via the “Survio” - online platform: that for oncologists by Italian Medical Research (IMR) included 37-questions and that for people with RCC and caregivers by Italian Association of Kidney Cancer Patients (ANTURE) included 27-questions. Both addressed the same key RCC treatment aspects: guidelines, prognostic scores, adjuvant and first-line therapies, treatment personalization, cytoreductive nephrectomy, biomarkers, toxicity, bone metastases, QoL and home care. Responses included multiple-choice questions and 5-point Likert scales to rank priorities, but some questions required multiple answers, to collect opinions more exhaustively. In Step II, a panel of Italian RCC- focused oncologists met on October 24-25, 2024, to evaluate surveys results and extract key themes. In Step III, data from patients and oncologists’ surveys were compared to identify areas of alignment and divergence. Finally, the expert panel established a definitive ranking of research priorities. Results: Of the 467 oncologists in the platform, 156 (33.4%) completed the survey (53% male, 47% female). Similarly, 107 of 312 (34.3%) people with RCC and caregivers (69% male, 31% female) completed the patient-directed survey. Both groups identified adjuvant therapy, personalized first-line treatment strategies, including intensification and deintensification, and biomarkers development as shared top priorities for future research in the top 3 places of the ranking. In addition, some key divergences emerged in priority rankings: patients emphasized more the need for focus on bone metastases (ranked 6th), QoL data in clinical trials (ranked 7th) and the management of toxicities (ranked 10th),all absent from the oncologists’ top 10. Conversely, oncologists prioritized topics like unmet need about biologic features of long responders to IO+IO combination therapy (ranked 5th), the prognostic score (ranked 8th), and the need of real world evidence studies (ranked 10th), which were less prominent for patients. Conclusions: The top 10 Italian priorities project successfully confirms the need for active listening to people with cancer, to help in establishing the future directions for research and treatment, aligning the differences and developing a ranking recognized by both clinicians and people with RCC.