Abstract 1765P
Background
For patients (pts) with la/mUC, systemic therapy (ST), including chemotherapy and immunotherapy, offers benefits such as improved overall survival (OS). There is no published systematic literature review (SLR) reporting on recent treatment patterns and reasons for potential undertreatment in la/mUC. We aimed to comprehensively characterize rates of no ST (NST) and associated reasons in this population.
Methods
We conducted a Cochrane guideline-based SLR of real-world evidence of NST in pts with la/mUC published from 2017-2022 (including a study date of 2015 or later). Studies published in English, Spanish, French, and German languages from any country were included.
Results
Among 2439 identified studies, a total of 29 reported first-line NST rates. Of these, 8 studies were European-based, where NST rates were highest in UK studies (70%-74%), followed by Denmark (64%), the Netherlands (48%-53%), and Spain (40%). Twelve US-based studies reported NST rates of 14%-60%; 9 studies from the rest of the world, including Japan, Canada, and Russia, reported NST rates of 9-63%. Among the 29 studies reporting percentage of pts with NST, 6 reported clinical characteristics and 8 reported survival rates in untreated pts compared with those of treated pts. Of the 6 studies describing characteristics of pts with NST, statistical analyses were performed in only 2, reporting that older age and poor performance status were significantly associated with NST. Of the 8 studies reporting survival, the median OS was 2.0-6.9 months for pts with NST and 9.2-34.5 months for pts receiving ST.
Conclusions
Our analysis of 29 relevant studies showed that there was significant heterogeneity in the populations studied and in the reported NST rates across studies, settings, and geographies. Notwithstanding, a substantial proportion of pts with la/mUC are undertreated as evidenced by the large variability of NST rates reported. Future research is needed to fully elucidate the reasons for this undertreatment, given the availability of effective treatments for this population.
Clinical trial identification
Editorial acknowledgement
Editorial support was provided by Katherine Quiroz-Figueroa of ClinicalThinking, and was funded by Merck (CrossRef Funder ID: 10.13039/100009945) as part of an alliance between Merck 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
T. Wilke: Financial Interests, Personal, Full or part-time Employment: Institut für Pharmakoökonomie und Arzneimittellogistik, Cytel Inc.; Financial Interests, Personal, Advisory Role: Novo Nordisk, AbbVie, Merck, GSK, Bristol Myers Squibb, LEO Pharma, Bayer, Boehringer Ingelheim. L. Zhang, M.G. Musat: Financial Interests, Personal, Full or part-time Employment: Cytel. E. Hubscher, S. Harricharan: Financial Interests, Personal, Full or part-time Employment: Cytel; Financial Interests, Institutional, Other, Consulting: Merck. M. Kearney: Financial Interests, Personal, Full or part-time Employment: Merck; Financial Interests, Personal, Stocks/Shares: Merck, Novartis, UCB Biopharma SPRL.