Abstract 1995P
Background
Contemporary, real-world data on eligible pts receiving systemic tx following progression on first-line (1L) mUC therapy are needed to inform tx algorithms and identify potential gaps in the mUC care pathway. The objective of this analysis was to determine the prevalence and predictors of 2L tx receipt in pts with mUC in Germany.
Methods
This study identified adults with incident mUC (ICD-10 C65-68 and C77-79) from Jan 2015 to Jun 2021, using data from 2 statutory health insurance claims databases (Jan 2013-Jun 2022; ≈8 million pts). Pts were observed for ≥12 mo post incident mUC diagnosis (index) or until death. Baseline (BL) characteristics were identified 24 mo before index, and multivariable logistic regression analyzed factors associated with receiving 2L tx.
Results
Of 4,290 pts with mUC who were identified, 1,779 (41.5%) received 1L tx (mean age, 69.1 y; male, 74.2%; mean Charlson Comorbidity Index [CCI] score, 5.6; mean follow-up [FU], 19.6 mo). Of these pts, 699 (39.3%) received 2L tx (mean age, 67.6 y; male, 75.3%; mean CCI score, 5.3; mean FU, 22.8 mo). The number of pts with incident mUC who received 2L tx increased over time (index year 2015: 78 pts [11.2%]; 2020: 132 pts [18.9%]). The most common 2L txs were immune checkpoint inhibitors (462 pts [66.1%]), followed by non–platinum-based chemotherapy (non-PBC) in 121 pts (17.3%), and PBC in 116 pts (16.6%). Younger pts and those without other primary malignancies at BL were more likely to receive 2L tx (Table).
Conclusions
A high proportion of pts (60.7%) did not receive 2L tx. Pts who received 2L tx were generally younger and healthier with slightly lower CCI scores and fewer non-UC primary malignancies. Tx rates may be underestimated due to the potential for unaccounted txs from clinical trials. Further research is needed to clarify barriers to accessing 2L tx in this patient population. Table: 1995P
Factors associated with receiving 2L tx in pts with mUC
| Variable | Odds ratio (95% Cl) | p value |
| Age at index (continuous) | 0.98 (0.97-0.99) | Clinical trial identificationEditorial acknowledgementEditorial support was provided by Nucleus Global and was funded by Merck. Legal entity responsible for the studyMerck (CrossRef Funder ID: 10.13039/100009945), as part of a previous alliance between Merck and Pfizer. FundingThis study was sponsored by the healthcare business of Merck KGaA, Darmstadt, Germany (CrossRef Funder ID: 10.13039/100009945) and was previously conducted under an alliance between the healthcare business of Merck KGaA, Darmstadt, Germany and Pfizer. DisclosureG. Niegisch: Financial Interests, Personal, Invited Speaker: Roche, MEDAC, Pfizer, BMS, AstraZeneca, Astellas; Financial Interests, Personal, Advisory Board: Roche, Sanofi, BMS, Merck, Pfizer, Ipsen, Janssen; Financial Interests, Personal, Other, Travel, congress registrations: Roche, Pfizer, Merck. M. Kearney: Financial Interests, Personal, Full or part-time Employment: Merck ; Financial Interests, Personal, Stocks or ownership: Novartis, Merck, UCB. J. Krieger: Financial Interests, Personal, Full or part-time Employment: Cytel ; Financial Interests, Personal, Advisory Role: Merck. U. Osowski: Financial Interests, Personal, Full or part-time Employment: Merck Healthcare Germany GmbH, Weiterstadt, Germany, an affiliate of Merck KGaA; Financial Interests, Personal, Stocks/Shares: Merck. B. Deiters: Financial Interests, Personal, Full or part-time Employment: GWQ ServicePlus AG. U. Maywald: Financial Interests, Personal, Full or part-time Employment: AOK PLUS. T. Wilke: Financial Interests, Personal, Full or part-time Employment, Employment by IPAM, which received financial support from Cytel to conduct the claims data analyses: IPAM. M.J. Grimm: Financial Interests, Personal, Advisory Board: Astellas Pharma, AstraZeneca, Bayer/Vital, Bristol Myers Squibb, Eisai, Eusa Pharma, Gilead, Ipsen, MSD, Novartis, Pfizer, Roche Pharma AG, Takeda, Merck; Financial Interests, Personal, Other, travel, accommodations, and expenses: Bristol Myers Squibb, Merck; Financial Interests, Personal, Advisory Board, honoraria: Astellas Pharma, AstraZeneca, Bristol Myers Squibb, Eusa Pharma, Ipsen, MSD, Pfizer; Financial Interests, Personal, Research Funding: Bristol Myers Squibb, Intuitive Surgical. Resources from the same session1978P - Accurate detection of urothelial carcinoma by whole-genome methylation profiling of urinary cell-free DNAPresenter: Huiqin Guo Session: Poster session 13 1979P - Disitamab vedotin (DV) plus toripalimab (T) in unresectable locally advanced or metastatic urothelial carcinoma (la/mUC): Long-term outcomes from a phase Ib/II studyPresenter: Li Zhou Session: Poster session 13 1980P - Association of PD-L1 expression with clinical response to TAR-200 in the phase IIb SunRISe-1 trialPresenter: Evanguelos Xylinas Session: Poster session 13 1981P - Cabozantinib plus durvalumab in patients with advanced and chemotherapy-treated urothelial carcinoma (UC) and variant histology (VH): An open-label, phase II, single-arm proof-of-concept trial: ARCADIA study. Subgroup analysis for bone metastasisPresenter: Marco Stellato Session: Poster session 13 1982P - Post hoc analysis of outcomes according to prior chemotherapy (CT) response and platinum agent in the international SAUL study of atezolizumab (atezo) for urinary tract carcinoma (UTC)Presenter: Begona Perez Valderrama Session: Poster session 13 1983P - Feasibility and efficacy of split-dose cisplatin with atezolizumab for cisplatin-ineligible urothelial carcinoma (SOGUG-AUREA): Final resultsPresenter: Guillermo Antonio De Velasco Oria Session: Poster session 13 1984P - Efficacy and safety of disitamab vedotin combined with gemcitabine as neoadjuvant therapy for muscle-invasive bladder cancer: A multi-center, single-arm, phase II trialPresenter: Chu Yang Session: Poster session 13 1985P - Retrospective database analysis of real-world treatment patterns and sequencing in locally advanced or metastatic urothelial carcinoma patients receiving sacituzumab govitecanPresenter: Ronac Mamtani Session: Poster session 13 1986P - Prospective evaluation of BCG unresponsive bladder cancer carcinoma in situ identifies genetic mechanisms of immunotherapy resistance and targeted therapy using an ultra-sensitive next generation sequencing minimal residual disease (MRD) assayPresenter: Joshua Meeks Session: Poster session 13 This site uses cookies. Some of these cookies are essential, while others help us improve your experience by providing insights into how the site is being used. For more detailed information on the cookies we use, please check our Privacy Policy.
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