1765P Undertreatment rates, associated factors, and survival among patients with locally advanced or metastatic urothelial cancer (la/mUC): A systematic literature review

Wilke, T; Zhang, L.; Hubscher, Elizabeth; Musat, Mihaela; Harricharan, Sharada; Kearney, Mairead

doi:10.1016/j.annonc.2022.07.1843

Cited by 3 publications

(1 citation statement)

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“…Previous US real-world studies reported underutilization of systemic treatment for la/mUC, with 42%-65% of patients not receiving any systemic therapy between 2000 and 2017. 8-12 , 21 Recent literature shows the low utilization of systemic therapy (14%-60% of patients were not receiving systemic therapy) 22 , 23 ; however, another US-based study reported a higher utilization rate (28% did not receive 1L systemic therapy) in patients with la/mUC. 24 Present cross-sectional surveys align more toward the latter than the prior study, in which physicians estimated that less than a quarter (23%) of their patients had not received systemic therapy.…”

Section: Discussionmentioning

confidence: 99%

Evaluating Oncologists’ Practice Patterns and Decision-Making in Locally Advanced or Metastatic Urothelial Carcinoma: The US Physician PARADIGM Study

Gupta,

Costantino,

Ike

et al. 2023

The Oncologist

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Background The treatment landscape for locally advanced/metastatic urothelial carcinoma (la/mUC) has evolved. This study examined US prescribing patterns and clinical decision-making for first-line (1L) and first-line maintenance (1LM) treatment. Materials and Methods US-based oncologists (N = 150) completed an online survey on patient demographics, practice patterns, and important factors considered in 1L/1LM selection. Multivariable logistic regression was used to assess factors associated with more vs less frequent 1L/1LM prescribing. Results Physician reports estimated that 23% of patients with la/mUC had not received any systemic therapy in the previous 6 months; however, 46% received 1L, 32% received second-line, and 22% received subsequent-line systemic treatments. Of patients who were receiving 1L treatment, 72% were estimated to be receiving 1L platinum-based chemotherapy. Around 69% of patients eligible for 1LM received the treatment. Physicians categorized as frequent prescribers reported overall survival (OS), disease control rate (DCR), and rate of grade 3/4 adverse events (AEs) as factors associated with 1L treatment selection (all P < .05). OS, rate of grade 3/4 immune-mediated AEs, and inclusion in institutional guidelines were reported as attributes used in 1LM treatment selection (all P < .05). Multivariable analysis revealed OS, DCR, and rate of grade 3/4 AEs as important factors in oncologists’ 1L treatment selection; academic practice setting and use of Response Evaluation Criteria in Solid Tumors version 1.1 were associated with 1LM use (all P < .05). Conclusion OS and AEs were found to be relevant factors associated with offering 1L and 1LM treatment. Variability exists in physicians’ decision-making in the real-world setting for la/mUC.

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Section: Discussionmentioning

confidence: 99%

Evaluating Oncologists’ Practice Patterns and Decision-Making in Locally Advanced or Metastatic Urothelial Carcinoma: The US Physician PARADIGM Study

Gupta,

Costantino,

Ike

et al. 2023

The Oncologist

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Nationwide Study of Real-World Treatment Patterns and Clinical Outcomes in Patients with Metastatic Urothelial Carcinoma in Hungary

Maráz,

Nagy,

Macher

et al. 2023

Adv Ther

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Introduction Data describing real-world treatment patterns in patients with metastatic urothelial carcinoma (mUC) in Central-Eastern Europe are scarce, and data from Hungary have not been published. This retrospective, nationwide, real-world study investigated patient characteristics, treatment patterns, comorbidities, and clinical outcomes in patients with mUC in Hungary. Methods Adults diagnosed with mUC from January 2016 through June 2021 were identified using the National Health Insurance Fund Administration database. Overall survival (OS) was estimated using the Kaplan–Meier method. Results In total, 2523 patients with mUC were identified. Median follow-up was 7.1 months. Overall, 50% of patients received an identified systemic anticancer treatment; within this subgroup, first-line treatment was platinum-based chemotherapy (PBC) in 86%, non-PBC in 8%, and immune checkpoint inhibitor (ICI) in 6%. The proportion of patients receiving treatment increased from 41% in 2016 to 59% in 2020, driven by increased use of first-line PBC or first-line ICI treatment. Comorbidities were more common in patients receiving first-line ICI treatment vs PBC or non-PBC and in patients receiving carboplatin + gemcitabine vs cisplatin + gemcitabine. Overall, only 24% received a second-line treatment. Unadjusted median OS from the start of first-line treatment in the PBC, non-PBC, and ICI subgroups was 12.8, 7.5, and 6.3 months, respectively. Median OS from date of diagnosis in untreated patients was 7.8 months. OS comparisons adjusted for differences in baseline characteristics between subgroups could not be performed. Conclusion To our knowledge, this is the first study to assess treatment patterns in patients with mUC in clinical practice in Hungary, using the National Health Insurance Fund Administration. Rates of first- and second-line treatment were consistent with those observed in other countries. Avelumab first-line maintenance treatment became available for reimbursement in Hungary in late 2022, after the study period. Given the evolving landscape of reimbursed treatments in Hungary, further analyses are warranted. Supplementary Information The online version contains supplementary material available at 10.1007/s12325-023-02694-9.

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Treatment patterns, survival, and healthcare utilisation and costs in patients with locally advanced and metastatic bladder cancer in Denmark 2015–2020

Nørgaard,

Mailhac,

Fagerlund

et al. 2023

Acta Oncologica

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1765P Undertreatment rates, associated factors, and survival among patients with locally advanced or metastatic urothelial cancer (la/mUC): A systematic literature review

Cited by 3 publications

References 0 publications

Evaluating Oncologists’ Practice Patterns and Decision-Making in Locally Advanced or Metastatic Urothelial Carcinoma: The US Physician PARADIGM Study

Evaluating Oncologists’ Practice Patterns and Decision-Making in Locally Advanced or Metastatic Urothelial Carcinoma: The US Physician PARADIGM Study

Nationwide Study of Real-World Treatment Patterns and Clinical Outcomes in Patients with Metastatic Urothelial Carcinoma in Hungary

Treatment patterns, survival, and healthcare utilisation and costs in patients with locally advanced and metastatic bladder cancer in Denmark 2015–2020

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