Abstract 783P
Background
Clinical trials demonstrated improved outcomes among pts with mUC receiving PD-1 and PD-L1 inhibitors but real-world evidence is limited.
Methods
Retrospective study of adult pts with mUC initiating PD-1/L1 inhibitors in 1L or 2L setting between 5/1/2016-1/31/2019 within the US Oncology Network (USON), a network of community oncology practices. Descriptive and Kaplan-Meier analyses were conducted to evaluate baseline characteristics, treatment patterns and clinical outcomes using data from USON’s electronic heath record.
Results
In the 1L setting (n=393), the median age (range) at initiation was 77 (42, 90+), 74% were male, and 29.4% had ECOG performance status (PS) >2. PD-L1 status for these patients is not available. Majority of patients received atezolizumab (ATEZO, n=180) and pembrolizumab (PEMBRO, n=177), 36 (9%) patients received other PD-1/L1 inhibitors. For patients who received ATEZO and PEMBRO, respectively, median follow-up durations (range) from treatment initiation were 4.2 (0, 34.1) and 4.2 (0, 32.7) months (mo); median durations of therapy (range) were 2.6 (0, 33.6) and 2.6 (0, 21.8) mo; and median overall survival (OS) durations (95% confidence interval [CI]) were 9.9 (8.3, 12.8) and 11.0 (8.3, not reached[NR]) mo. In the 2L setting (n=366), the median (range) age at initiation was 70 (29, 90+), 74% were male, and 27.0% had ECOG PS >2. Majority of patients received ATEZO (n=148), PEM (n=145), and nivolumab (NIVO, n=68), 5 (1%) patients received other PD-1/L1 inhibitors. For patients who received ATEZO, PEMBRO, and NIVO, respectively, median follow-up durations (range) from initiation were 3.7 (0, 31.3), 4.4 (0, 22.7) and 5.5 (0, 24.2) mo; median durations of therapy (range) were 2.1 (0, 31.3), 2.3 (0, 22.5) and 2.3 (0, 19.1) mo; and median OS durations (95% CI) were 8.0 (4.7, 14.0), 11.1 (8.1, NR) and 7.8 (6.2, 10.9) mo.
Conclusions
Outcomes among pts receiving 1L and 2L PD-1/L1 inhibitors in real world are consistent with clinical trial results. Future research should examine influence of treatment choice and pt characteristics including PD-L1 status on outcomes.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
McKesson Life Sciences.
Funding
Merck & Co., Inc.
Disclosure
M. Boyd: Full/Part-time employment: McKesson Life Sciences. S. Annavarapu: Full/Part-time employment: McKesson Life Sciences. G.K. Doshi: Speaker Bureau/Expert testimony: Astellas Medivation. K. Imai: Full/Part-time employment: Merck & Co., Inc.; Shareholder/Stockholder/Stock options: Merck & Co., Inc. E.I. Sbar: Full/Part-time employment: Merck & Co., Inc.; Shareholder/Stockholder/Stock options: Merck & Co., Inc.; Shareholder/Stockholder/Stock options: Bristol Myers Squibb; Shareholder/Stockholder/Stock options: Pfizer. J.L. Godwin: Full/Part-time employment: Merck & Co., Inc. H. Li: Full/Part-time employment: Merck & Co., Inc.; Shareholder/Stockholder/Stock options: Merck & Co. Inc. G. Sonpavde: Advisory/Consultancy: Agensys; Advisory/Consultancy: Astellas Pharma; Advisory/Consultancy: AstraZeneca; Advisory/Consultancy: Bayer; Advisory/Consultancy: Bristol-Myers Squibb; Advisory/Consultancy: Eisai; Advisory/Consultancy: EMD Serono; Advisory/Consultancy: Exelixis; Advisory/Consultancy: Genentech; Advisory/Consultancy: Janssen; Advisory/Consultancy: Merck; Advisory/Consultancy: Novartis; Advisory/Consultancy: Sanofi; Speaker Bureau/Expert testimony: Clinical Care Options/NCCN; Speaker Bureau/Expert testimony: Onclive; Speaker Bureau/Expert testimony: Physician Education Resource; Speaker Bureau/Expert testimony: Research to Practice; Research grant/Funding (institution): Bayer; Research grant/Funding (institution): Boehringer Ingelheim; Research grant/Funding (institution): Celgene; Research grant/Funding (institution): Janssen; Research grant/Funding (institution): Merck; Research grant/Funding (institution): Onyx; Research grant/Funding (institution): Pfizer; Research grant/Funding (institution): Sanofi.