Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2023

Treatment patterns and criteria used to determine platinum eligibility in metastatic urothelial cancer: a real-world survey in Australia (#242)

Neil Milloy 1 , Diah Elhassen 2 , Melissa Kirker 3 , Mia Unsworth 1 , Rachel Montgomery 1 , Allison Thompson 3 , Caspian Kluth 1 , Annalisa Varrasso 4 , Greer Bennett 4 , Mairead Kearney 5 , Nuno Costa 6 , Jane Chang 3
  1. Adelphi Real World, Bollington, Cheshire, UK
  2. Pfizer, Sydney, NSW, Australia
  3. Pfizer, New York, NY, USA
  4. Merck Healthcare Pty Ltd, an affiliate of Merck KGaA, Macquarie Park, NSW, Australia
  5. Merck Healthcare KGaA, Darmstadt, Germany
  6. Pfizer, Porto Salvo, Portugal

Aims: Treatment guidelines for metastatic urothelial cancer (mUC) recommend first-line (1L) treatment based on platinum eligibility. In Australia, at data collection, the standard approach for 1L treatment of mUC was platinum-based chemotherapy (PBC), whilst immune checkpoint inhibitors (ICIs) were commonly used as second-line treatment. This study investigated treatment patterns and clinical practice criteria used to determine platinum eligibility in patients with mUC in Australia.

Methods: Data were drawn from the Adelphi mUC Disease-Specific Programme, a cross-sectional survey conducted in December 2021-June 2022 in Australia. Oncologists/urologists extracted data from medical charts for their next 8 consecutive eligible adult patients with mUC. Demographics, clinical characteristics, and treatment patterns were collected. Descriptive analyses were conducted.

Results: 29 physicians provided data on 239 patients (mean age, 70 years [sd 9.61]); male, 72%; ECOG performance status [PS] 0-1, 71%). The most common initial tumour location was bladder (84%), and the most common metastatic sites were lymph node (66%), visceral organ (64%), and bone (32%); 30% of patients had 1 metastasis, 38% had 2, and 32% had ≥3. Of patients with known platinum-eligibility status at 1L (n=236), 90% (n=213) were platinum-eligible (54% cisplatin-eligible, 36% carboplatin-eligible/cisplatin-ineligible). Renal function and ECOG PS were considered most frequently regarding eligibility for cisplatin (92%/65%) and carboplatin (86%/40%). On average, cisplatin-eligible patients were younger than carboplatin-eligible/cisplatin-ineligible patients (66.0 vs 73.5 years). Of cisplatin-eligible patients (n=128), 84% received PBC (cisplatin in 81% [n=104]; carboplatin in 3% [n=4]), and 16% (n=20) received ICI treatment. Of carboplatin-eligible/cisplatin-ineligible patients (n=85), 91% (n=77) received PBC (cisplatin in 2% [n=2]; carboplatin in 88% [n=75]).

Conclusions: Most patients with mUC in Australia were platinum-eligible, and these patients primarily received 1L PBC. Future studies should continue to evaluate concordance with and deviation from guideline recommendations, and outcomes by platinum eligibility. These data are necessary for determining subsequent treatment options.

 

  1. Previously presented at ANZUP 2023, “FPN: 15”, “Neil Milloy et al.” - Reused with permission.