Abstract 148P
Background
Tx guidelines for mUC recommend tx based on PE. Most real-world analyses have not included physician-confirmed PE. This study investigated tx patterns and clinical practice criteria to determine PE for pts with mUC.
Methods
Data were obtained from the Adelphi mUC Disease-Specific Programme, a point-in-time survey conducted from Dec 2021 to Mar 2022 in KR and TW. Oncologists and urologists extracted demographic, clinical, PE, and tx pattern data for their next 8 consecutive eligible pts with mUC. Descriptive analyses were conducted.
Results
Physicians (N=76; KR, n=52; TW, n=24) provided data on 426 pts with mUC (KR, n=278; TW, n=148), during or after 1L tx, with known physician-determined PE status. Mean pt age was 68.4 years, and 74% were male. The percentage of pts considered platinum eligible was 86% (67% eligible for cisplatin [cis] and carboplatin [carbo]; 19% cis ineligible). For cis eligibility, physicians most commonly considered renal function (79%) and ECOG PS (72%); for carbo eligibility, physicians used renal function (87%) and age (53%). At initial mUC diagnosis, pts frequently had metastases in lymph nodes (72%), lungs (32%), and bones (20%). Cis-eligible pts were on average younger than cis-ineligible and PI pts (66.5, 71.1, and 73.9 years, respectively), and a greater proportion had an ECOG PS of 0-1 at mUC diagnosis (90%, 78%, and 50%, respectively). 1L tx by PE status is shown in the table. Table: 148P
PE | PI | ||
1L regimen received and known PE status N=426 | Cis and carbo eligible n=285 | Cis ineligible but carbo eligible n=83 | Cis and carbo ineligible n=58 |
Cis-based regimen n=247 (58%) | 236 (83%) | 7 (8%) | 4 (7%) |
Carbo-based regimen n=63 (15%) | 2 (1%) | 58 (70%) | 3 (5%) |
Other chemotherapy n=22 (5%) | 5 (2%) | 4 (5%) | 13 (22%) |
ICI n=50 (12%) | 24 (8%) | 8 (10%) | 18 (31%) |
Other n=4 (1%) | 1 (<1%) | 2 (2%) | 1 (2%) |
Best supportive care only n=40 (9%) | 17 (6%) | 4 (5%) | 19 (33%) |
ICI, immune checkpoint inhibitor. |
Conclusions
Platinum chemotherapy was the most common 1L tx for in pts with mUC, consistent with guideline recommendations. ICI use in 1L was low in KR and TW, and was mainly in PI pts. Future studies should continue to evaluate concordance with and deviation from guideline recommendations, and outcomes by PE.
Clinical trial identification
Editorial acknowledgement
Editorial support was provided by Katherine Quiroz-Figueroa of ClinicalThinking, and was funded by Pfizer as part of an alliance between Pfizer and Merck (CrossRef Funder ID: 10.13039/100009945).
Legal entity responsible for the study
Pfizer as part of an alliance between Pfizer and Merck.
Funding
This study was sponsored by Pfizer as part of an alliance between Pfizer and Merck (CrossRef Funder ID: 10.13039/100009945).
Disclosure
N. Milloy, M. Berry, C. Kluth, C. Bleasdale: Financial Interests, Personal, Full or part-time Employment: Adelphi Real World. R. Montgomery: Financial Interests, Personal, Full or part-time Employment, Immediate Family Member: AstraZeneca; Financial Interests, Personal, Full or part-time Employment: Adelphi Real World; Financial Interests, Personal, Stocks/Shares, Immediate Family: AstraZeneca. M. Kirker, N. Costa: Financial Interests, Personal, Full or part-time Employment: Pfizer; Financial Interests, Personal, Stocks/Shares: Pfizer. M. Kearney: Financial Interests, Institutional, Full or part-time Employment: Merck; Financial Interests, Personal, Stocks/Shares: Merck, Novartis Pharma, UCB Biopharma SPRL. W.E.M. Mohamed: Financial Interests, Personal, Full or part-time Employment: Pfizer. J. Chang: Financial Interests, Personal, Full or part-time Employment: Pfizer; Financial Interests, Personal, Stocks/Shares: Pfizer, BMS, Bayer.
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