Treatment of metastatic urothelial carcinoma in the United Kingdom, France, Germany, Italy, and Spain.

Introduction: The treatment landscape of metastatic urothelial carcinoma (mUC) has evolved with the emergence of programmed cell death protein 1/ligand 1 (PD-1/L1) inhibitors. This study assessed mUC treatment patterns in Europe.

Methods: Data were derived from the Adelphi mUC Disease Specific Programme™ (November 2020 to April 2021), a large, cross-sectional, patient record-based survey of physicians in France, Germany, Italy, Spain, and the United Kingdom. Patient characteristics, treatment patterns across lines of therapy, and treatment durations were assessed.

Results: Physicians (N = 232) provided data for 1922 patients with mUC. Mean (SD) patient age at the time of data collection was 69.1 (7.9) years, and 81% presented with bladder tumors. Most patients received platinum-based chemotherapy in first-line (cisplatin plus gemcitabine, 43%; carboplatin plus gemcitabine, 28%), followed by PD-1/L1 inhibitors in second-line (pembrolizumab, 35%; atezolizumab, 19%). In third-line, 41% received best supportive care and 36% received single-agent chemotherapies. Mean treatment duration was longer in second-line than first-line (6.1 vs 4.8 months).

Conclusions: Most patients received platinum-based chemotherapy in first-line, followed by a PD-1/L1 inhibitor. A substantial proportion received best supportive care after second-line. Findings indicate unmet need for the later-line treatment of mUC and provide important context for the emergence of novel therapies.