Understanding Treatment Patterns and Outcomes among Patients with De Novo Unresectable Locally Advanced or Metastatic Urothelial Cancer: A Population-Level Retrospective Analysis from Alberta, Canada

Abstract

Despite a high disease burden, real-world data on treatment patterns in patients with unresectable locally advanced or metastatic urothelial carcinoma (la/mUC) in Canada are limited. This retrospective, longitudinal cohort study describes treatment patterns and survival in a population of patients with de novo unresectable la/mUC from Alberta, Canada, diagnosed between 1 January 2015 and 31 December 2019, followed until mid-2020. The outcomes of interest were systemic therapy treatment patterns and overall survival (OS). Of 206 patients, most (65.0%, n = 134) did not receive any systemic therapies. Of 72 patients (35.0%) who received first-line systemic therapy, the median duration of treatment was 2.8 months (IQR 3.3). Thirty-five patients (48.6% of those who received first-line therapy) received subsequent second-line therapy, for a median of 3.0 months (IQR 3.3). In all patients (n = 206), the median OS from diagnosis was 5.3 months (95% CI, 4.5–7.0). In patients who received treatment, the median OS from the initiation of first-line and second-line systemic therapy was 9.1 (6.4–11.6) and 4.6 months (3.9–19.2), respectively. The majority of patients did not receive first-line systemic therapy, and, in those who did, survival outcomes were poor. This study highlights the significant unmet need for safe and efficacious therapies for patients with la/mUC in Canada.

Administration of Enfortumab Vedotin after Immune-Checkpoint Inhibitor and the Prognosis in Japanese Metastatic Urothelial Carcinoma: A Large Database Study on Enfortumab Vedotin in Metastatic Urothelial Carcinoma

“…Advanced urothelial carcinoma poses significant challenges in terms of diagnosis, treatment, and patient outcomes [1][2][3]. This aggressive form of urothelial carcinoma Cancers 2023, 15, 4227 2 of 7 often presents at an advanced stage, leading to limited treatment options and a poor prognosis.…”

The Genomic Landscape of Urothelial Carcinoma with High and Low ERBB2 Expression

“…Among patients with UC, approximately 20% of cases are muscle invasive at time of diagnosis, with a higher likelihood of metastasis or recurrence following radical surgical resection and a significantly lower 5-year survival rate [2]. Currently, outcomes are poor in patients with advanced UC treated with first-and second-line systemic therapy, specifically platinum-based therapies, immune checkpoint inhibitors (i.e., pembrolizumab), more recently, tyrosine kinase inhibitors (erdafitinib) [3], and antibody-drug conjugates (ADC) (i.e., enfortumab vedotin and sacituzumab govitecan) [4,5]. Because of this, there is a need for investigating novel therapies in advanced UC.…”