Real-world epidemiology and treatment patterns of patients with locally advanced or metastatic urothelial carcinoma: Retrospective analysis of Diagnosis Procedure Combination claims data in Japan

• Published in: International journal of urology Vol. 31; no. 7; pp. 730 - 738
• Main Authors: Asakawa, Keiko, Waratani, Miina, Massey, Olivia, Holbrook, Tim, Kondo, Makoto, Saito, Atsushi, Nishiyama, Hiroyuki
• Format: Journal Article
• Language: English
• Published: Australia Wiley Subscription Services, Inc 01.07.2024; John Wiley and Sons Inc
• Subjects: Electronic medical records; Epidemiology; Gemcitabine; Metastases; Metastasis; Original; Original : Clinical Investigation; Patients; Pembrolizumab; Platinum; Trends; Urothelial carcinoma; Japan; retrospective analysis; epidemiology; real-world; locally advanced/ metastatic urothelial carcinoma; Japan; treatment patterns
• ISSN: 0919-8172; 1442-2042; 1442-2042
• DOI: 10.1111/iju.15450

Evaluate real-world epidemiologic trends and treatment patterns in newly diagnosed patients with locally advanced or metastatic urothelial carcinoma (la/mUC) in Japan. This retrospective analysis included adults with newly diagnosed la/mUC in Japan (January 2015-December 2019) from a nationwide-linked electronic medical record Diagnostic Procedure Combination claims dataset. Outcomes included epidemiologic trends (incidence and prevalence), baseline demographics, clinical characteristics, and treatment patterns in newly diagnosed patients with la/mUC before (2015-2017) and after (2018-2019) approval of pembrolizumab in Japan. Of 975 patients included, 76.4% were men; 71.6% were aged 70 years or older. Most cases (70.5%) were of the bladder. Between 2015 and 2019, the annual age-adjusted incidence increased from 6.8 to 12.4 per 100 000; the annual age-adjusted period prevalence increased from 13.0 to 25.2 per 100 000; and 307 (31.5%) and 668 (68.5%) patients were diagnosed from 2015 to 2017 and 2018 to 2019, respectively. Overall, 731 (75%) patients received systemic anticancer therapy; all received 1 line and 50.2% received 2 lines of therapy; 78.3% of patients received gemcitabine plus platinum-based therapy and 2.2% received pembrolizumab as first-line treatment. First-line treatment rates increased from 69.4% to 77.5% after pembrolizumab approval. Of 367 patients who received second-line treatment, 22.3% received gemcitabine plus platinum-based therapy; 14.7% received pembrolizumab. In the Japanese regions considered, incidence and prevalence of newly diagnosed la/mUC increased over time and first-line treatment with pembrolizumab increased after approval.