ArticleThe oncologist2025
Noninterventional retrospective study of standard-of-care systemic treatment patterns and outcomes in US patients with advanced urothelial carcinoma.
Article in The oncologist, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundFirst-line platinum-based chemotherapy (1L PBC) followed by avelumab 1L maintenance (1LM) in patients without disease progression after 1L PBC is a standard-of-care treatment in locally advanced/metastatic urothelial carcinoma (la/mUC). We examined real-world treatment patterns and outcomes in patients with la/mUC treated in the US and characterized early adoption of avelumab 1LM following US Food and Drug Administration approval in June 2020. MATERIALS AND
methodsThis retrospective cohort study identified patients ≥ 18 years diagnosed with la/mUC between January 2015 and July 2021 using electronic health records from the Flatiron Health database. Treatment patterns and baseline characteristics were described by type of 1L treatment. Real-world progression-free survival (rwPFS) and real-world overall survival (rwOS) were determined using the Kaplan-Meier method.
resultsA total of 4387 patients were included, with 3706 (84.5%) receiving systemic treatment. The most common 1L therapy was cisplatin-based therapy (33.3%), followed by carboplatin-based (30.9%) and immuno-oncology (IO) therapies (28.0%). Patients treated with 1L cisplatin-based therapy had longer median rwPFS and rwOS from 1L initiation (8.0 and 18.3 months, respectively) vs patients treated with 1L carboplatin-based therapy (6.4 and 13.2 months), or IO therapies (6.1 and 14.2 months). Among eligible patients, early use of avelumab 1LM was 29%. Approximately half (51.7%) of treated patients received second-line (2L) treatment, 16.8% received no 2L treatment, and 31.5% remained on 1L at end of study.
conclusionOur findings contribute to our understanding of optimal treatment sequencing options based on individual patient characteristics in a rapidly evolving treatment landscape.
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