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Treatment patterns and overall survival in metastatic urothelial carcinoma in a real-world, US setting

2019; Elsevier BV; Volume: 60; Linguagem: Inglês

10.1016/j.canep.2019.03.013

1877-783X

Jason C. Simeone, Beth Nordstrom, Ketan M. Patel, Helen Mann, Alyssa Klein, Laura Horne,

Cancer Immunotherapy and Biomarkers

Metastatic 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). We 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. A 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. Consistent 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.