Abstract 1756P
Background
Data describing the Tx patterns of mUC in routine clinical practice in Eastern Europe are scarce. This study aimed to describe RW Tx patterns and overall survival (OS) in pts with mUC in Hungary where access to immunotherapy (IO) has been restricted to a named-patient reimbursement program since 2018.
Methods
This study consisted of a retrospective analysis of the Hungarian National Health Insurance Fund (NHIFA) database, a comprehensive data source covering all Hungarian patients (10 million people). The study period was from January 1, 2016, through June 30, 2021, with a 1-year baseline period. Adults with an incident mUC diagnosis (ICD-10 codes C65-C68, denoting malignant neoplasms of urinary tract) who had evidence of metastatic disease (ICD-10 codes C77-79) and ≥2 outpatient or ≥1 inpatient claims were identified. Pts were classified into groups by type of first-line (1L) Tx received: (1) platinum-based chemotherapy (PB-CT), (2) non–PB-CT, or (3) IO monotherapy as per label. We used descriptive statistics to summarize the results. The Kaplan-Meier method was used to estimate median OS. Unadjusted median OS was calculated from date of treatment initiation by type of 1L Tx and from mUC diagnosis for the untreated (no systemic Tx) cohort.
Results
A total of 2,523 eligible pts with mUC were identified, of whom 49.8% (n=1,256) received 1L systemic Tx. Among treated pts, 1L Tx was PB-CT in 86.1% (n=1,082), non–PB-CT in 7.7% (n=97), and IO in 6.1% (n=77). Unadjusted median OS (95% CI) was 12.8 months (11.5-14.1) with 1L PB-CT, 7.5 months (5.8-10.1) with 1L non PB-CT, 6.3 months (2.9-9.0) with 1L IO, and 7.8 months (6.7-8.8) in untreated pts.
Conclusions
This first-of-its-kind nationwide, retrospective, RW study provides insights into the RW Tx of mUC in Hungary, where only half of all pts with mUC received systemic Tx. In those who did, the majority received guideline-recommended Tx with PB-CT regimens in the 1L. Future research should evaluate unmet needs and reasons for undertreatment, the impact of limited access to IO Tx, and assess outcomes when the recently approved IO Tx as 1L maintenance is reimbursed.
Clinical trial identification
Editorial acknowledgement
Editorial support was provided by Katherine Quiroz-Figueroa of ClinicalThinking, and was funded by Merck as part of an alliance between Merck (CrossRef Funder ID: 10.13039/100009945) and Pfizer.
Legal entity responsible for the study
Merck, as part of an alliance between Merck and Pfizer.
Funding
Merck (CrossRef Funder ID: 10.13039/100009945), as part of an alliance between Merck and Pfizer.
Disclosure
A.C. Maraz: Financial Interests, Personal, Advisory Role: MSD, Merck; Financial Interests, Personal, Speaker’s Bureau: MSD, Roche, Merck, BMS. E. Tischler, C. Csongvai: Financial Interests, Personal, Full or part-time Employment: Merck. M. Kearney: Financial Interests, Institutional, Full or part-time Employment, I am in full-time employment as Director, EVD Strategy Lead Avelumab LCM: Merck; Financial Interests, Personal, Stocks/Shares: Merck, Novartis Pharma, UCB Biopharma SPRL. All other authors have declared no conflicts of interest.