Abstract 2382P
Background
The available real-world (RWD) evidence on the management of la/mUC is limited but of high importance to understand how to incorporate new treatment options in this setting. The present study describes the clinical characteristics, treatment patterns and outcomes in patients (pts) with la/mUC in Northern Spain.
Methods
Retrospective observational analysis from 16 hospitals across 12 provinces. The study population included adult pts diagnosed with la/mUC (January 1,2007-December 31, 2019) followed from the index date until death, loss to follow-up or end of study. Median overall survival (OS) and progression-free survival (PFS) were determined using the Kaplan-Meier method.
Results
We included 1231 pts (median age:68 years;83% men). 74% had ≥1 medical comorbidity (hypertension 48%; DM 22.5%; CAD 13%; COPD 12%). Primary tumour locations: bladder (89.2 %), renal pelvis (6.4%), ureter (4.3%), and urethra(0.1%). 70% of the pts had localized disease at diagnosis, cystectomy was the predominant treatment (95%) and 30% received perioperative chemotherapy. Out of 1231 pts, 292 (24%) never received systemic therapy. From 939 pts (76%) treated with 1st-line therapy, 50% were fit for cisplatin. Only 53% (n=493) progressed to receive a second line (2L) and 22% (n=210) received a third line(3L). Chemotherapy was the most common treatment used across all lines (1L[92%], 2L [74%] and 3L[74%]) and immunotherapy represented 3%, 25% and 22%,in 1L, 2L and 3L respectively. 28 pts (3%) were included in clinical trials. Median OS (95% CI) was 12.1(11.3–12.9) months in the overall group and 14.5 in pts who received 1st-line cisplatin-gemcitabine. From the start of the 1L, 2L and 3L treatment, median PFS was 1L:5.0(4.5-5.4);2L: 3.2(2.8-3.5);3L:2.6(2.3-2.9) months. No unexpected toxicity was reported.
Conclusions
The results of this Spanish RWD analysis are comparable to previous studies conducted in other regions of the world and highlight unmet needs such as the proportion of pts who never receive systemic treatment and the notable decrease in the number of pts progressing to second and subsequent lines of therapy hindering the access to new effective treatments developed in this context.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
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