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• W3202488424 abstract "Programmed death 1/ligand 1 inhibitors (PD-1/L1i) are indicated for first-line (1L) therapy in aUC patients who are cisplatin-ineligible and have high PD-L1 expression or who are ineligible for any platinum-containing chemotherapy regardless of PD-L1 status. Current, real-world data on PD-1/L1i use in 1L are limited. This study characterized 1L treatment patterns and subsequent second-line (2L) therapy in both cisplatin-eligible and ineligible patients with aUC. Patients aged ≥18 years diagnosed with aUC (Stage IV UC) from May 2016–July 2020 were included; activity in the nationwide Flatiron Health de-identified electronic health record-derived database ≤90 days post-aUC diagnosis date (index) was required. The cohort received 1L therapy on/after index, with follow-up through October 2020. Patient characteristics and 1L/2L treatment patterns were described in the population overall and by cisplatin eligibility (defined per Galsky criteria). 4,063 patients were included; 3,119 (76.8%) received 1L therapy, with median follow-up of 8.5 (IQR 3.9-17.1) months. Mean age of patients at aUC diagnosis was 72.2 years; 72.6% were male; 1,229 (39.4%) received a 1L PD-1/-L1i. Approximately half of 1L treated patients were cisplatin-ineligible (50.9%). A higher proportion of cisplatin-ineligible (50.1%) than cisplatin-eligible (28.3%) patients were treated with PD-1/-L1i in 1L (Table). Only 42.5% of treated patients received 2L therapy, with differences based on the type of 1L therapy received: 24.6% following 1L PD-1/L1i vs 54.5% following 1L chemotherapy.Table: 704P1L Treated Patients (n=3,119)1L Cisplatin-Ineligible (n=1,588)1L Cisplatin-Eligible (n=1,531)Male, n (%)2264 (72.6)1070 (67.4)1194 (78.0)Age at aUC diagnosis, mean (SD)72.2 (9.0)75.0 (7.9)69.4 (9.2)1L therapy type, n (%) PD-1/-L1 inhibitor1229 (39.4)796 (50.1)433 (28.3) Carboplatin-based791 (25.4)435 (27.4)356 (23.3) Cisplatin-based772 (24.8)220 (13.9)552 (36.1) Other chemotherapy219 (7.0)89 (5.6)130 (8.5) Clinical trial59 (1.9)24 (1.5)35 (2.3) Other49 (1.6)24 (1.5)25 (1.6)Post 1L, n (%) Received 2L therapy1326 (42.5)585 (36.8)741 (48.4) Still on 1L212 (6.8)98 (6.2)114 (7.4) No therapy post 1L473 (15.2)197 (12.4)276 (18.0) Died after 1L1108 (35.5)708 (44.6)400 (26.1) Open table in a new tab Approximately 3/4 of patients received systemic treatment following aUC diagnosis, with PD-1/-L1i accounting for ∼40% of 1L regimens. Following 1L PD-1/L1i, a lower proportion (∼1/4) of patients received 2L therapy relative to those treated with 1L chemotherapy (∼1/2). There remains significant unmet need for safe and efficacious therapies for patients with aUC following 1L PD-1/L1i therapy." @default.
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• W3202488424 date "2021-09-01" @default.
• W3202488424 modified "2023-10-17" @default.
• W3202488424 title "704P Treatment patterns among patients with advanced urothelial carcinoma (aUC) in the USA" @default.
• W3202488424 doi "https://doi.org/10.1016/j.annonc.2021.08.100" @default.
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