276MO - Epidemiology, treatment (tx) patterns, and clinical outcomes of patients (pts) with locally advanced or metastatic urothelial cancer (la/mUC) in Taiwan: A retrospective cohort study

Background

Real-world (rw) data on the management of la/mUC in Asia are limited. We report the epidemiology, tx patterns, and outcomes in pts with la/mUC in Taiwan.

Methods

Adults diagnosed with la/mUC between 2011 and 2020 were identified in the Taiwan National Health Insurance Research Database. The index date was the date of la/mUC diagnosis. Pts were followed up until death or end of 2021 and grouped as treated or untreated. Pts receiving first-line (1L) systemic tx ≤12 months after diagnosis were assigned to the treated group; 1L tx was identified using drug claims of systemic tx ≤30 days from the first prescription. Descriptive statistics were used. Multivariate Cox proportional hazards models (adjusted for age, sex, modified Charlson Comorbidity Index, and UC stage at diagnosis) were used to examine indicators of receiving tx and overall survival (OS).

Results

The crude rate of la/mUC increased (167%) from 0.6 per 100,000 persons in 2011 to 1.6 in 2020. A total of 2,894 pts with la/mUC were identified; 59.8% were male, and median age at diagnosis was 72 years. Median follow-up was 271 days. Approximately half (55.1%) of pts received 1L tx, and median time from diagnosis to tx initiation was 40 days. Most treated pts received 1L platinum-based chemotherapy (PBC; 85.4%), with cisplatin- or carboplatin-based tx in 57.4% and 28.0%, respectively. Pts were more likely to receive 1L tx if they were younger, had a more recent diagnosis, or were treated by an oncologist (Table). Median OS from diagnosis was longer in treated vs untreated pts (13.9 vs 4.0 months; adjusted hazard ratio [HR], 0.55 [95% CI, 0.50-0.60]). Table: 276MO

*HR >1 indicates that the variable was associated with a higher probability of receiving tx vs the reference group. ^†Includes retired, homemakers, and family member with no income.

Conclusions

To our knowledge, this is the first retrospective nationwide study of la/mUC in Taiwan. Nearly half of pts were untreated, highlighting an unmet need. Because most treated pts received 1L PBC, future research should assess rw OS with avelumab 1L maintenance after PBC.

Clinical trial identification

Editorial acknowledgement

Editorial support was provided by Nucleus Global.

Legal entity responsible for the study

Merck.

Funding

This study was sponsored by Merck (CrossRef Funder ID: 10.13039/100009945).

Disclosure

C. Wu: Financial Interests, Personal, Other, Contracted by IQVIA Solutions Taiwan Ltd. to conduct the research funded by Merck Healthcare KGaA: IQVIA Solutions Taiwan Ltd. L. Young: Financial Interests, Personal, Full or part-time Employment: Merck Pte. Ltd., Singapore, an affiliate of Merck KGaA. A. Lee: Financial Interests, Personal, Full or part-time Employment: Merck Ltd., Taiwan, an affiliate of Merck KGaA. M. Ku, Y. Hsieh: Financial Interests, Personal, Other, Contracted by IQVIA Solutions Taiwan Ltd. to conduct the research funded by Merck Healthcare KGaA: IQVIA Solutions Taiwan Ltd. H. Lin, K. Lin, K. Chou: Financial Interests, Personal, Full or part-time Employment: IQVIA Solutions Taiwan Ltd. M. Kearney: Financial Interests, Personal, Full or part-time Employment: Merck; Financial Interests, Personal, Stocks or ownership: Merck, Novartis, UCB. L. Chien: Financial Interests, Personal, Other, Contracted by IQVIA Solutions Taiwan Ltd. to conduct the research funded by Merck Healthcare KGaA: IQVIA Solutions Taiwan Ltd.