150P - Use of neoadjuvant chemotherapy for non-metastatic muscle-invasive bladder cancer in Asia-Pacific

Background

Although neoadjuvant chemotherapy (NAC) with radical cystectomy (RC) is the recommended standard treatment for non-metastatic muscle-invasive bladder cancer (MIBC), there has been an inconsistent adoption of NAC for MIBC. This study describes the use of NAC prior to RC in Asia-Pacific (APAC).

Methods

We conducted a cross-sectional survey with 32 urologists, 8 medical oncologists and 10 radiation oncologists with ≥8 years of experience managing early-stage bladder cancer patients across Australia, Hong Kong, Japan, South Korea, Singapore, and Taiwan. Physicians completed a questionnaire that assessed their use of neoadjuvant treatment for non-metastatic MIBC and could opt out if the question was not within their clinical practice.

Results

When considering patients eligible for RC, a median of 50% (IQR 30-70%) receive NAC. Most respondents (83%) preferred gemcitabine and cisplatin in cisplatin-eligible patients. Around 21% of respondents preferred upfront RC in cisplatin-ineligible patients, while 71% preferred carboplatin-based NAC. About 58% of respondents preferred upfront RC in platinum-ineligible patients and the remaining preferred use of NAC. The frequency of immune-checkpoint inhibitors administration in cisplatin ineligible and platinum ineligible patients was 3% and 19%, respectively. Only 20% of respondents used biomarkers for treatment selection, of which PD-L1 status was most frequently utilised (median of 55% of patients). Table: 150P

Conclusions

The rate of NAC is reasonably high in the APAC, and platinum-based regimens remain preferred while immune checkpoint inhibitors are more common in those ineligible for chemotherapy.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

IQVIA Asia Solutions Pte Ltd.

Funding

MSD International GmbH (Singapore Branch).

Disclosure

R. Kanesvaran: Financial Interests, Institutional, Invited Speaker: Astellas, Johnson and Johnson, Ipsen, Amgen, BMS, MSD, Novartis, AstraZeneca, Sanofi; Financial Interests, Institutional, Advisory Board: Johnson and Johnson, Pfizer, Ipsen, Amgen, BMS, MSD, Bayer, AstraZeneca, Ferring; Financial Interests, Institutional, Research Grant: Sanofi, Eisai, Johnson and Johnson; Non-Financial Interests, Personal, Leadership Role, Past President: Singapore Society of Oncology; Non-Financial Interests, Personal, Leadership Role, President: SIOG; Non-Financial Interests, Personal, Leadership Role, Vice Chairman: Singapore Cancer Society; Non-Financial Interests, Personal, Leadership Role, Medical Advisory Board Member: International Kidney Cancer Coalition. E. Kikuchi: Financial Interests, Personal, Advisory Board: MSD. H. Kitamura: Financial Interests, Personal, Invited Speaker: Astellas, AstraZeneca, MSD, Sanofi, Bristol Myers Squibb, Merck Biopharma, Takeda, Janssen; Financial Interests, Personal, Advisory Board: Kissei; Financial Interests, Institutional, Invited Speaker: AstraZeneca; Financial Interests, Institutional, Research Grant: Takeda. J.H. Ku, D.M.C. Poon: Financial Interests, Personal, Advisory Board: MSD. L.S. Lee: Financial Interests, Personal, Research Grant: Janssen; Financial Interests, Personal, Other, Steering Meeting honorarium: AstraZeneca, Bayer, Astellas, Janssen; Financial Interests, Personal, Advisory Board, Steering Meeting honorarium: MSD; Financial Interests, Personal, Advisory Board: AstraZeneca, MSD, Bayer, Astellas, Janssen. T. Lin: Financial Interests, Personal and Institutional, Other, Honoraria for presentations: Astellas, Ferring pharmaceuticals, Janssen, Bayer, AstraZeneca; Non-Financial Interests, Personal and Institutional, Member, Urological oncology committee: Taiwan Urological Association; Non-Financial Interests, Personal and Institutional, Product Samples, Docetaxel/cabazitaxel compounds: Sanofi; Financial Interests, Personal, Advisory Board: MSD. H. Nishiyama: Financial Interests, Personal, Research Grant: Astellas, Ono Pharmaceutical, Takeda Pharmaceutical; Financial Interests, Personal, Invited Speaker: MSD, Chugai Pharmaceutical, Astellas. A.C.F. Ng: Financial Interests, Personal, Writing Engagements: MSD; Financial Interests, Personal, Other, Consulting fees: Cornerstone medical, Agiis; Financial Interests, Personal, Invited Speaker: Boston Scientific, Olympus, Ipsen, Janssen, Bayer; Financial Interests, Personal, Advisory Board: Newlife Medical Limited, Nonagen, Jiangsu Hengrui Medicine; Non-Financial Interests, Personal, Product Samples: Olympus, Janssen. J. Ng: Financial Interests, Personal, Full or part-time Employment: IQVIA; Financial Interests, Institutional, Sponsor/Funding, corporate-sponsored research: MSD. H.K. Seo: Financial Interests, Personal, Research Grant: MSD, Roche, Ono-BMS, Baselia, Astellas, AstraZeneca, Janssen; Financial Interests, Personal, Advisory Board: MSD; Financial Interests, Personal, Invited Speaker: MSD, Astellas, Boryung. R.R. Shamaileh, C. Spiteri: Financial Interests, Personal, Full or part-time Employment: MSD. E.M. Tan: Financial Interests, Personal, Full or part-time Employment: IQVIA; Financial Interests, Institutional, Sponsor/Funding, corporate-sponsored research: MSD. B. Tran: Financial Interests, Personal and Institutional, Research Grant: Bristol Myers Squibb, MSD, Ipsen, Astellas, Janssen-Cilag, Amgen, Pfizer, Genentech, AstraZeneca, Bayer; Financial Interests, Personal and Institutional, Invited Speaker: Astella Pharma, Janssen-Cilag, Sanofi, Tolmar, Amgen, Bristol Myers Squibb, Pfizer, Janssen, Bayer; Financial Interests, Personal and Institutional, Sponsor/Funding: Amgen, Astellas Pharma; Financial Interests, Personal, Other, Individual consulting/advisory role: Amgen, Astellas Pharma, Bayer, Sanofi, Tolmar, Janssen-Cilag, Bristol Myers Squibb, Ipsen, MSD Oncology, IQVIA, Novartis, Pfizer/EMD Serono, AstraZeneca, Roche Molecular Diagnostics. Y. Tsai: Financial Interests, Personal, Advisory Board: MSD.