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 session2008P - Assessing response durability and survival after second-line pembrolizumab in advanced urothelial carcinoma: A multicenter validation of a risk modelPresenter: Samer Salah Session: Poster session 13 2010P - Trifunctional anti-EpCAM/CD3 bsAb catumaxomab intravesically for high and intermediate risk non muscle invasive bladder cancer (HMR-NMIBC): Interim analysis of a phase I studyPresenter: Aleksander Antoniewicz Session: Poster session 13 2011P - Neoadjuvant immunotherapy-driven bladder preservation for muscle-invasive bladder cancer: A multicenter, propensity score-matched cohort studyPresenter: Jiao Hu Session: Poster session 13 2012P - Role of first-line immunotherapy in urothelial cancer with bone metastases: A national cancer database analysis of 3971 patientsPresenter: Zin Myint Session: Poster session 13 2013P - First preliminary results of artificial intelligence generated treatment recommendations for urothelial cancer based on multidisciplinary cancer conferences from the KITTU projectPresenter: Gregor Duwe Session: Poster session 13 2014P - Overall survival (OS) results in phase II trial of cabozantinib (CABO) plus durvalumab (DURVA) in patients with urothelial carcinoma (UC) or non-UC variant histologies (VH) after platinum chemotherapy (ARCADIA)Presenter: Patrizia Giannatempo Session: Poster session 13 2015P - Serum nectin-4: Prognostic and predictive value in bladder cancer?Presenter: Kerstin Junker Session: Poster session 13 2016P - Evaluation of event-free survival (EFS) as a surrogate endpoint for overall survival (OS) in muscle-invasive bladder cancer (MIBC) following neoadjuvant (NAD) therapyPresenter: Cora Sternberg Session: Poster session 13 2017P - Intrinsic molecular difference between bladder and upper tract urothelial carcinomas and its impacts in treatment responsePresenter: Jiwon Kim 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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