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Medientyp:
E-Artikel
Titel:
Platinum eligibility (PE) criteria for patients with metastatic urothelial carcinoma (mUC): Results of a physician survey in 5 European countries
Beschreibung:
<jats:p> 696 </jats:p><jats:p> Background: The standard of care for mUC is platinum-based chemotherapy (PBC) followed by avelumab first-line (1L) maintenance in patients without disease progression. Guidelines for mUC recommend 1L treatment based on eligibility for PBC (cisplatin or carboplatin), but the definition of PE remains unclear, and little is known about criteria used by European physicians to define PE in clinical practice. In this cross-sectional study, we assessed treatment decision-making factors and clinical thresholds used by European physicians determine PE and examined their alignment with published US physician thresholds. Methods: Physicians from France, Germany, Italy, Spain, and the UK completed a quantitative online survey in Aug/Sep 2022. We adapted Gupta et al’s ASCO-GU 2019 and ASCO 2022 US-based surveys, which identified thresholds for clinical criteria used by US physicians to define PE. This EU survey included clinical parameters with different age and creatinine clearance (CrCl) thresholds, plus Eastern Cooperative Oncology Group performance status (ECOG PS) and other relevant criteria. Participants reported the percentage of patients they perceived were platinum eligible and ranked criteria to determine PE. All analyses used descriptive statistics. Results: 503 physicians (69% oncologists, 31% urologists) completed the quota-based survey. Most had been in practice for >10 years (69%), treated 5-19 patients with mUC per month (58%), and practiced in a public teaching hospital (40%). Most patients who received 1L systemic treatment were PE (77%), ranging from 75% in Italy to 79% in Spain. Most respondents chose >80 years (33.2%) or >75 years (24.1%) as the age threshold for platinum ineligibility. Age thresholds selected were significantly different across countries, years of practice, and practice settings (p<0.001). Responses for ECOG PS and peripheral neuropathy thresholds for platinum ineligibility were evenly split between ECOG PS ≥2 (40.6%) and ≥3 (45.3%) and between grade ≥2 (44.3%) and ≥3 (41.7%) peripheral neuropathy. The most frequent responses are summarized (Table). Conclusions: Physicians in Europe considered most patients with mUC to be platinum eligible. Criteria to determine PE were broadly consistent with previous US-based studies, except for age. The low age threshold observed is at odds with the older age of the mUC patient population. Wider use of these criteria could support clinical decision-making, reduce variations in care, and improve patient outcomes. [Table: see text] </jats:p>