Temporal changes in treatment patterns by age group and functional status before and after PD-1/L1 inhibitor approvals in advanced urothelial carcinoma

• Published in: Frontiers in oncology Vol. 13; p. 1210208
• Main Authors: Doshi, Gurjyot K., Li, Haojie, Burcu, Mehmet, Annavarapu, Srinivas, Wells, Karen, Imai, Kentaro, Moreno, Blanca Homet, Singhal, Puneet, Mamtani, Ronac
• Format: Journal Article
• Language: English
• Published: Frontiers Media S.A 02.10.2023
• Subjects: advanced urothelial carcinoma; immunotherapy; observational study; Oncology; real-world; treatment pattern
• ISSN: 2234-943X; 2234-943X
• DOI: 10.3389/fonc.2023.1210208

Introduction Metastatic urothelial carcinoma (mUC) has poor prognosis. A high unmet need exists for novel treatment for those who are unfit for platinum-based chemotherapy. Methods We aimed to describe real-world temporal changes in patient characteristics and 1L treatment selection for mUC patients in the United States following the approval of anti-PD-1/L1 treatments. This study was a retrospective, observational study using anonymized and structured oncology electronic medical record (EMR) data from IQVIA and the US Oncology Network iKnowMed (USON). Results After approval of 1L anti-PD-1/L1 treatment for mUC, there is a marked increase in the use of 1L anti-PD-1/L1 monotherapies, accompanied by a proportional decrease in 1L platinum-based treatments and non-guideline-based therapy; particularly among the elderly (> 75 years) and those with poor ECOG performance status (ECOG PS 2+). Discussion Anti-PD-1/L1 monotherapies fulfill the prior unmet need of frail mUC patients who are ineligible for platinum-based therapies.