EBANO study: real-world data from patients with locally advanced/metastatic urothelial carcinoma (la/mUC) in Northern Spain

Background

Limited real-world data exist on managing locally advanced/metastatic urothelial carcinoma (la/mUC), crucial for predicting outcomes and integrating new treatments. This study explores la/mUC in Northern Spain.

Methods

Retrospective observational analysis from 16 hospitals across 12 provinces. The study population included adult patients diagnosed with la/mUC (1 January 2007-31 December 2019). Median overall survival and progression-free survival were determined using the Kaplan–Meier method.

Results

A total of 1230 patients were included, 83% were males, median age was 68, and 70% had a smoking history. The most common primary tumor was bladder (89.2%) followed by renal pelvis (6.4%), ureter (4.3%), and urethra (0.1%) and most of them (91%) were pure urothelial tumors. Cystectomy was the predominant treatment of localized disease (69%) and 30% received perioperative chemotherapy. Twenty-four percent of la/mUC patients never received systemic therapy and out of 934 patients treated with first-line (1L) therapy, 55% were fit for cisplatin. Progression to further lines of treatment was poor, only 53% (n = 492) progressed to receive a second line and 22% (n = 209) to a third line. Median overall survival (95% confidence interval) was 12.2 (11.3-12.9) months for the entire cohort and 14.5 and 10.8 months for patients who received first-line cisplatin or carboplatin-based chemotherapy, respectively. No unexpected toxicity was reported.

Conclusions

This Spanish real-world data analysis echoes previous findings and highlights unmet needs, including the proportion of patients not receiving systemic treatment and the limited progression to subsequent lines of therapy, hampering access to new effective treatments.