Real-world treatment (tx) patterns and clinical outcomes in patients (pts) with locally advanced or metastatic urothelial carcinoma (la/mUC) in Germany: Results of a retrospective observational study (CONVINCE)
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Titel:
Real-world treatment (tx) patterns and clinical outcomes in patients (pts) with locally advanced or metastatic urothelial carcinoma (la/mUC) in Germany: Results of a retrospective observational study (CONVINCE)
Beschreibung:
551 Background: Platinum-based chemotherapy (PBC) is the standard-of-care first-line (1L) tx for pts with la/mUC (followed by avelumab 1L maintenance in pts without progressive disease since its approval in Germany in Jan 2021). This study describes demographics, tx patterns, and clinical outcomes for pts with la/mUC treated in routine clinical practice in Germany between 2019 and 2021. Methods: CONVINCE, a retrospective, multicenter medical chart review study, was initiated in Dec 2021 and included adult pts who received 1L tx for la/mUC between 2019 and 2021. All pts were required to have ≥6 months of follow-up data available after end/start of 1L, depending on the type of tx received. Fully anonymized data were obtained from 27 oncology or urology institutions (8 hospitals and 19 office-based practices) across Germany. Descriptive statistics were used to analyze the results, and Kaplan-Meier methods were used to compute time-to-event outcomes. Pts were classified into 3 groups: (A) PBC with end of tx between Jan 2019 and Sep 2021 and (B) immuno-oncology (IO) therapy and (C) other non-PBC tx, both with start of tx between Jan 2019 and Sep 2021. Results: Of 188 pts included, median age at start of 1L was 70 years, 72.3% were male, most had ECOG PS 0/1 (92.5%), and the majority (60.1%) were treated by medical oncologists. A total of 143 pts (group A) received PBC (PBC + gemcitabine, 88.1%; PBC + non-gemcitabine agents, 8.4%; and cisplatin monotherapy, 3.5%). Cisplatin + gemcitabine (82.5%) was used more often than carboplatin + gemcitabine (17.5%). Six pts were treated with avelumab 1L maintenance following PBC. In group B, 36 pts (19.1%) received IO monotherapy (atezolizumab, 44.4%; pembrolizumab, 41.7%). In group C, 9 pts (4.8%) received non-PBC tx. Clinical outcomes in groups A and B are shown in the Table. Results for group C are not shown due to small sample size. Conclusions: CONVINCE describes characteristics, tx patterns, and outcomes in pts with la/mUC in routine clinical practice in Germany. In adherence with tx guidelines, most pts received PBC in 1L. New IO approvals, including avelumab 1L maintenance and other novel agents, could improve outcomes in pts with la/mUC. Further real-world studies should be performed to evaluate the uptake of these options within routine care. [Table: see text]