Contemporary data from the advanced urothelial cancer (UC) setting are scarce. Here, we describe treatment (tx) patterns and outcomes among > 350 patients (pts) in Germany.
Data were extracted from pt medical records from office-based urologists and urology clinics in Germany. Adult pts (age ≥ 18 y) diagnosed with T4b, N2-3 and/or M1 UC and received first-line (1L) or second-line (2L) palliative chemotherapy from 2009 to 2016 were included. The index date was the start date of first systemic therapy. We described tx patterns and clinical characteristics; Kaplan-Meier method assessed overall survival (OS). Cox regression adjusted for age, Eastern Cooperative Oncology Group performance status (ECOG PS) and liver metastases, stratified by hospital/office, compared tx.
Among 368 included pts, 356 and 107 received 1L and 2L tx, respectively. At the start of 1L therapy, mean age was 68 y, 73% of pts were male, 74% were current/ex-smokers and 63% had metastatic disease. In 1L, 75% of pts received dual-combination tx, most commonly gemcitabine + cisplatin (GemCis; 83%). In 2L, 74% received single-agent tx, most commonly vinflunine (66%). In 1L, 12-month OS was 60%, slightly higher with GemCis (65%) than with other tx (52%). No difference in OS by sex or smoking status was noted. Pts with and without renal impairment (creatinine clearance
Outcomes in advanced UC tx in pts in this large real-world data study are comparable with clinical trials. Despite frequent use of cisplatin-based 1L tx and vinflunine 2L tx, per recent guidelines, outcomes are generally still poor.
Clinical trial identification
Legal entity responsible for the study
F. Hoffman-La Roche Ltd.
F. Hofman-La Roche Ltd.
G. Niegisch: Research funding: 4SC AG Lecturer: Pfizer Pharma GmbH, Pierre Fabre Pharma GmbH, Roche Pharma AG Consulting or Advisory Role: Bristol-Myers Squibb, Roche Parma AG, IMS Health AG, medac GmbH Travel, Accommodations, Expense: Pfizer Pharma GmbH, Roche Pharma AG, Bristol-Myers Squibb. S-W. Lin: Receive salary and stocks from Genentech/Roche. J. Pavlova: Employee: Roche. A. Gondos, A. Rudolph, G. Haas: Employed by QuintilesIMS during the study. M.W. Kramer: Received honories for advisory board memberships and presentations from Roche, Pierre Fabre, Bristol-Myers Squibb, Novartis, Bayer, Astellas, Sanofi, Ipsen and Eisai. All other authors have declared no conflicts of interest.