707P Treatment pattern and overall survival among patients with locally advanced or metastatic urothelial carcinoma: Results from a complete nationwide unselected real-world registry study in Denmark from 2010 to 2017

Aim: To investigate real-world overall survival (rwOS) and real-world progression-free survival (rwPFS) in locally advanced/metastatic urothelial carcinoma postplatinum and postprogrammed death receptor-1/death ligand 1 inhibitors. Patients & methods: Adult patients diagnosed with locally advanced/metastatic urothelial carcinoma from 1 January 2011 to 31 December 2018 and treated with taxane monotherapy or any therapy postplatinum and post-PD-1/L1 inhibitors were included from a nationwide electronic health record-derived oncology database. Results: Median rwOS among 72 patients treated with taxane monotherapy was 7.6 months (95% CI: 5.2–14.4) and rwPFS was 2.9 months (95% CI: 2.4–4.0). Among 208 patients treated with any therapy, median rwOS was 8.9 months (95% CI: 7.3–10.6) and rwPFS was 3.6 months (95% CI: 2.7–4.7). Conclusion: Short duration of rwOS and rwPFS were observed, highlighting the need for effective and safe treatments in this patient population.

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Real-world burden of illness and unmet need in locally advanced or metastatic urothelial carcinoma following discontinuation of PD-1/L1 inhibitor therapy: A Medicare claims database analysis

Urologic Oncology Seminars and Original Investigations ◽

10.1016/j.urolonc.2021.05.001 ◽

2021 ◽

Author(s):

Alicia K. Morgans ◽

Zsolt Hepp ◽

Sonali N. Shah ◽

Anne Shah ◽

Allison Petrilla ◽

...

Keyword(s):

Urothelial Carcinoma ◽

Real World ◽

Burden Of Illness ◽

Locally Advanced ◽

Unmet Need ◽

Inhibitor Therapy ◽

Database Analysis ◽

Claims Database ◽

Medicare Claims ◽

Metastatic Urothelial Carcinoma

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Ramucirumab plus docetaxel versus placebo plus docetaxel in patients with locally advanced or metastatic urothelial carcinoma after platinum-based therapy (RANGE): overall survival and updated results of a randomised, double-blind, phase 3 trial

The Lancet Oncology ◽

10.1016/s1470-2045(19)30668-0 ◽

2020 ◽

Vol 21 (1) ◽

pp. 105-120 ◽

Cited By ~ 9

Author(s):

Daniel P Petrylak ◽

Ronald de Wit ◽

Kim N Chi ◽

Alexandra Drakaki ◽

Cora N Sternberg ◽

...

Keyword(s):

Overall Survival ◽

Urothelial Carcinoma ◽

Locally Advanced ◽

Phase 3 ◽

Double Blind ◽

Metastatic Urothelial Carcinoma

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Real-world survival and treatment patterns of patients with locally advanced or metastatic urothelial carcinoma treated with second-line therapy after platinum-based chemotherapy.

Journal of Clinical Oncology ◽

10.1200/jco.2018.36.6_suppl.466 ◽

2018 ◽

Vol 36 (6_suppl) ◽

pp. 466-466

Author(s):

Jason C Simeone ◽

Beth L Nordstrom ◽

Ketan Patel ◽

Alyssa B Klein ◽

Laura Horne

Keyword(s):

Overall Survival ◽

Real World ◽

Median Overall Survival ◽

Locally Advanced ◽

Treatment Patterns ◽

Second Line ◽

Second Line Therapy ◽

Line Therapy ◽

Platinum Based Chemotherapy ◽

Metastatic Urothelial Carcinoma

466 Background: Median overall survival for patients with locally advanced/metastatic urothelial carcinoma (UC) who fail standard platinum-containing chemotherapy is 5–7 months, and there is no current standard of care for these patients. As immuno-oncology (IO) therapies are being developed for the treatment of UC, including some recent approvals, a better understanding of the current real-world treatment patterns and effectiveness of treatments is needed. Methods: Patients with locally advanced/metastatic UC receiving second-line therapy after platinum-based chemotherapy were identified from the Flatiron Oncology electronic medical record database from 2011–2016. Treatment patterns, including the most common regimens and total number of systemic therapy treatment lines, were characterized. Median overall survival (OS) and associated 95% confidence intervals (CI) were calculated from the start of second-line therapy using Kaplan-Meier curves. Results: A total of 476 patients met all study criteria; mean age was 70.1 ± 9.2 years and 74.2% were male; <3% were tested for PD-L1 during follow-up. Platinum-based chemotherapies were most commonly prescribed (Table 1), 4.4% received IO during second-line. Median OS from start of second-line therapy was 8.3 months (95% CI: 7.2–8.9). Conclusions: Real-world OS among locally advanced/metastatic UC patients who received second-line therapy after platinum-based chemotherapy was less than one year, similar to prior estimates. It remains to be seen how the introduction and increasing uptake of IO may affect OS. [Table: see text]

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Real-world systemic therapy utilization in Medicare patients with locally advanced or metastatic urothelial carcinoma diagnosed between 2008 and 2012

Journal of Geriatric Oncology ◽

10.1016/j.jgo.2020.08.005 ◽

2020 ◽

Author(s):

Michaela A. Dinan ◽

Mihaela V. Georgieva ◽

Yanhong Li ◽

Tian Zhang ◽

Michael Harrison ◽

...

Keyword(s):

Urothelial Carcinoma ◽

Real World ◽

Systemic Therapy ◽

Locally Advanced ◽

Medicare Patients ◽

Metastatic Urothelial Carcinoma

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Real-world outcomes in patients with locally advanced or metastatic urothelial carcinoma receiving taxane monotherapy following platinum and anti-PD-1/L1 therapy.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.6_suppl.458 ◽

2020 ◽

Vol 38 (6_suppl) ◽

pp. 458-458

Author(s):

Zsolt Hepp ◽

Sonali Shah ◽

Katherine Tan ◽

Shreya Balakrishna

Keyword(s):

Urothelial Carcinoma ◽

Clinical Outcomes ◽

Real World ◽

Locally Advanced ◽

Progression Free Survival ◽

Disease Status ◽

Study Cohort ◽

Start Date ◽

Metastatic Urothelial Carcinoma ◽

Platinum Chemotherapy

458 Background: There are currently limited options for patients with locally advanced or metastatic urothelial carcinoma (la/mUC) following progression on platinum chemotherapy and anti-programmed death 1/death-ligand 1 (PD-1/L1) therapy. Further, limited data are available from clinical trials or real-world studies on outcomes in this population. This retrospective analysis investigated clinical outcomes in patients treated with taxane monotherapy, a commonly used and NCCN guideline-recommended option in this setting. Methods: Patients aged ≥18 years with histologically-confirmed diagnosis of la/mUC on or after 2011, ≥2 clinical visits, and sufficient relevant unstructured data were included from the de-identified nationwide Flatiron Health electronic health record-derived database. The study cohort included patients treated with taxane monotherapy (docetaxel, paclitaxel, or nab-paclitaxel) following anti-PD-1/L1 therapy and who have received prior platinum containing chemotherapy. Baseline characteristics, overall survival (OS), real-world progression-free survival (rwPFS) based on clinician documentation of disease status, and real-world response (rwR) based on clinician-confirmed radiologic assessments were reported. Patients were followed until death, data cutoff, or loss to follow up. Results: Among 276 patients treated following anti-PD-1/L1 therapy and who met all of the inclusion/exclusion criteria, 72 were treated with taxanes and also had documented prior platinum chemotherapy. Patients were mostly male (75%) and Caucasian (74%), with a mean age of 73 years. 65% had > 2 sites of metastasis at index (start date of taxane). Post index, median OS = 7.6 months (95% CI 5.2, 14.4) and median rwPFS = 2.9 months (95% CI, 2.4, 4.0). Among the 50 patients with ≥1 rwR assessment, confirmed rwR = 18% (95% CI: 9%, 32%). Conclusions: In the real-world setting, limited responses to taxanes and short duration of PFS and OS were observed in patients with la/mUC previously treated with a platinum and anti-PD-1/L1 therapy. There is a need for more effective therapies to improve clinical outcomes for this patient population.

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