Essential Research Priorities in Renal Cancer: A Modified Delphi Consensus Statement

Abstract

ABSTRACT Background: The identification of clear and focused research priorities is crucial to drive research forwards. Objective: To identify research priorities in renal cell carcinoma (RCC) through a multidisciplinary collaboration between clinicians, researchers and patients. Design: In phase one, 44 RCC experts provided 24 literature reviews within their field, summarising research gaps (RGs). Three expert discussion meetings and patient interviews were performed and identified 39 potential RGs. In phase two, experts (N=82) scored these gaps on a 9-point scale (1-3: Not important; 4-6: Important; 7-9: Critical) through a multistep Delphi process involving three online surveys and two further consensus meetings. The surveys aimed to reach a consensus, defined as ≥ 70% agreement by experts. Results and limitations: In the first Delphi Survey, the response rate was 56% (46/82), increasing to 67% (55/82) and 71% (58/82) in the second and third iterations respectively. Survey respondents were 45.7% urologists, 37.0% oncologists, 8.7% radiologists and 8.6% other specialists (pathologists, health economists, geneticist and scientists). The process resulted in the identification of fourteen crucial RGs, across a broad range of RCC themes. Key themes included further research into systemic therapies for RCC and management strategies that maximise quality of life, especially in “difficult to treat” patient groups and rarer RCC subtypes. Two crucial RGs relate to biomarkers and novel imaging approaches for both localised and metastatic disease, to enable prognostic risk stratification and individualize patient management. Study participants were from a UK and European setting; therefore, we acknowledge that the RGs identified represent European priorities. Conclusion: These RGs will facilitate international collaboration towards a concerted attempt to improve patients’ survival and quality of life.