Epidemiology and treatment patterns of patients with locally advanced or metastatic urothelial cancer in France: A non-interventional database study

BackgroundThe management of patients with locally advanced/metastatic urothelial cancer (la/mUC) has recently changed with the introduction of new first-line (1L) treatment options into ESMO Clinical Practice Guidelines. Limited data exists on the impact of these changes on patients with la/mUC in France. Here, we describe and assess the epidemiology and treatment patterns in this patient population.MethodsThis was a descriptive, non-interventional, retrospective study of adult ≥18 years) patients with la/mUC identified from the Programme de Médicalisation des Systèmes d’Information, the French hospital discharge database; data were extracted from 01 Jan 2020 to 31 Dec 2022. The primary objective was to estimate the annual incidence and prevalence of patients with la/mUC in the general population, and the annual incidence of patients with la/mUC treated in 1L. Other objectives were a description of patients’ characteristics and treatment patterns for those treated in 1L.ResultsOf 39,857 patients with la/mUC, 25,217 patients were newly diagnosed with no evidence of treatment for a cancer other than UC after la/mUC diagnosis during the study period. Prevalence and incidence rates ranged from 38.2–41.6 and 16.8–19.2 cases/100,000 people respectively, from 2020–2022; rates of prevalence and incidence were about four-fold higher in men than women and were higher in older (≥60 years) versus younger patients. In patients who received 1L treatment (N=15,101), incidence ranged from 7.9–11.2 cases/100,000 people from 2020–2022; at the date of 1L treatment the mean (standard deviation) age of patients was 71 (9.8) years and 79.5% were male. Of patients that received 1L therapy with at least 6 months of potential follow-up (N=11,893), 64.5% received only 1L of treatment, 93.6% received chemotherapy as 1L, and 11.9–19.3% had subsequent avelumab maintenance therapy from 2020–2022.ConclusionsIncidence rates of la/mUC increased over time in France during the study period, and most patients treated only received 1L of therapy. Avelumab usage remained low but increased over time. Further research is needed to assess the long-term impact of current 1L options.Editorial acknowledgementMedical writing support was provided by Glen Dorrington, PhD, on behalf of Lumanity, funded by Astellas Pharma, Inc.Legal entity responsible for the studyAstellas Pharma Europe Ltd.FundingAstellas Pharma Europe Ltd.DisclosureF. Joly Lobbedez: Financial Interests, Personal, Advisory Board, Consulting fees: Astellas, Pfizer, Merck. M. Roupret: Financial Interests, Personal, Advisory Role, Consulting fees: Ipsen, Astellas, Janssen, AstraZeneca, Bayer, BMS. R. Minacori, T. Strunz-McKendry, K. Leyland, M. Vuillet, M. Thomas: Financial Interests, Personal, Other, Employee: Astellas. All other authors have declared no conflicts of interest.