Treatment patterns and overall survival in metastatic urothelial carcinoma in a real-world,US setting |
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| Affiliation: | 1. Real-World Evidence, Evidera, Waltham, MA, USA;2. Teradata UK Ltd, London, UK;3. Global Medicines Development, AstraZeneca, Cambridge, UK;4. Oncology Business Unit, AstraZeneca, Gaithersburg, MD, USA;5. Independent Consultant, Fairfield, CT, USA;1. Moffitt Cancer Center, Department of Health Outcomes and Behavior, 4115 E. Fowler Ave., Tampa, FL 33617, United States;2. Moffitt Cancer Center, Center for Immunization and Infection Research in Cancer, 12902 USF Magnolia Drive, Tampa, FL 33612, United States;3. Moffitt Cancer Center, Department of Cancer Epidemiology, 12902 USF Magnolia Drive, Tampa, FL 33612, United States;4. Moffitt Cancer Center, Department of Biostatistics and Bioinformatics, 12902 USF Magnolia Drive, Tampa, FL 33612, United States;5. University of South Florida, Department of Family Medicine, 13330 USF Laurel Drive, Tampa, FL 33612, United States;6. University of South Florida, Department of Epidemiology & Biostatistics, 13201 Bruce B Downs Blvd, Tampa, FL 33612, United States;8. University of Florida, Department of Medicine, 1600 SW Archer Rd., Gainesville, FL 32608, United States;9. University of Florida Health, Department of Health Outcomes and Biomedical Informatics, 2004 Mowry Road, Ste 2245, Gainesville, FL 32610, United States;10. University of Florida Health, Cancer Population Sciences, 2004 Mowry Road, Ste 2245, Gainesville, FL 32610, United States;1. Department of Clinical Therapeutics, University of Athens, Athens, Greece;2. Division of Oncology, Department of Medicine, University Hospital, University of Patras Medical School, Patras, Greece;3. 1st Department of Medical Oncology, “Agios Savvas” Hospital, Athens, Greece;4. 3rd Department of Clinical Oncology, Theagenion Cancer Hospital, Thessaloniki, Greece;5. Department of Medical Oncology, University Hospital of Heraklion, and Medical School, University of Crete, Heraklion, Crete, Greece;6. “Mitera” Hospital, Athens, Greece;7. 2nd Department of Urology, Sismanoglio Hospital, School of Medicine, University of Athens, Athens, Greece;8. Department of Urology, Athens University Medical School, Laiko Hospital, Athens, Greece;9. Department of Medical Oncology, General Hospital of Chania, Chania, Greece;10. “Lefkos Stavros” Hospital, Athens, Greece;11. Department of Medical Oncology, Venizelio Hospital, Heraklion, Greece;12. Medical Oncology Department, 251 General Air Force Hospital, Athens, Greece;1. Department of Medical Oncology, AOU Ospedali Riuniti, Università Politecnica delle Marche, Ancona, Italy;2. Cancer Sciences Unit, University of Southampton, Southampton, UK;3. Dipartimento di Scienze Cliniche Specialistiche ed Odontostomatologiche, Clinica di Urologia, AOU Ospedali Riuniti, Università Politecnica delle Marche, Ancona, Italy;4. Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy;5. NIHR Wellcome Trust Clinical Research Facility, University of Southampton, Southampton, UK;1. Tom Baker Cancer Centre, Department of Oncology, University of Calgary, Calgary, AB, Canada;2. Departments of Oncology and Community Health Sciences, University of Calgary, Calgary, AB, Canada;3. Cross Cancer Institute, Department of Oncology, University of Alberta, Edmonton, AB, Canada;1. Department of ORL Head & Neck Surgery and Audiology, Odense University Hospital, University of Southern Denmark, Denmark;2. Department of Pathology, Odense University Hospital, Denmark;3. Department of ENT Head & Neck Surgery, Copenhagen University Hospital, Denmark;4. Department of ENT Head & Neck Surgery, Aalborg University Hospital, Denmark;5. Department of Oncology, Herlev Hospital, Denmark;6. Department of ENT Head & Neck Surgery, Aarhus University Hospital, Denmark;1. Léon Bérard Cancer Centre, 28 rue Laennec, 69008 Lyon, France;2. Cancer Research Centre of Lyon, UMR Inserm 1052 CNRS 5286 Centre Léon Bérard, 69008 Lyon, France;3. Section of Cancer Surveillance, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69008 Lyon, France;4. Nutrition and Metabolism Section, Biomarkers Group, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69008 Lyon, France;5. Nutrition and Metabolism Section, Nutritional Methodology and Biostatistics Group, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69008 Lyon, France;6. Nutrition Risk Assessment Unit, French Agency for Food, Environmental and Occupational Health & Safety (ANSES), 14 rue Pierre et Marie Curie, 94701 Maisons-Alfort Cedex, France;7. Agence Nationale de Santé Publique, Université Paris 13, Centre de Recherche en Epidémiologie et Statistiques, COMUE Sorbonne Paris Cité, 74 rue Marcel Cachin, 93017 Bobigny cedex, France |
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| Abstract: | BackgroundMetastatic urothelial carcinoma (mUC) treated with chemotherapy is associated with poor survival; however, as the field of immuno-oncology continues to evolve, new immunotherapies have recently become available. The current study aimed to assess real-world characteristics, treatment patterns, and overall survival (OS) of patients with mUC treated in the United States (US).MethodsWe conducted a retrospective, observational analysis of patients with mUC from the Flatiron Health longitudinal database from 2011 to 2017. Treatment patterns of patients who started systemic first-line therapy (1 L cohort) or second-line therapy following platinum-based first-line therapy (2 L cohort) were described using medication order and administration data. Kaplan-Meier analyses were used to assess OS from the start of first- and second-line therapy in the 1 L and 2 L cohorts, respectively.ResultsA total of 1811 patients qualified for the 1 L cohort (median age [range], 72 [32–84] years); 476 met the criteria for the 2 L cohort (median age [range], 71 [40–84] years). The most common first- and second-line therapies were carboplatin + gemcitabine (n = 562 [34.6%]) and atezolizumab (n = 90 [13.1%]), respectively, in the 1 L cohort. Median OS was 12.7 months (95% confidence interval [CI] 11.8, 13.4) in the 1 L cohort and 8.3 months (95% CI 7.2, 8.9) in the 2 L cohort.ConclusionsConsistent with clinical trial results, survival was poor in this real-world study in patients with mUC, indicating a continued unmet need. As immunotherapy becomes more commonplace in the treatment of mUC, future studies are needed to understand its real-world impact on survival. |
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| Keywords: | Chemotherapy Electronic health records Immunotherapy Urinary bladder neoplasms |
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