CLINICAL CHARACTERISTICS AND TREATMENT PATTERNS IN CISPLATIN ELIGIBLE VERSUS CISPLATIN INELIGIBLE MUSCLE INVASIVE BLADDER CANCER PATIENTS WITH INTENT FOR RESECTION: A MULTICOUNTRY RETROSPECTIVE CHART REVIEW IN EUROPE
Author(s)
Steffen Rausch, MD1, Ching-Yu Wang, BS, MS, PhD2, Patrick Squires, PharmD, PhD2, Lynn Huynh, MBA, MPH, DrPH3, Jordan A. Burdeau, MS, PhD3, Peter R. Zuckerman, MS3, Fariha Haque, BA3, Leili Young-Xu, BS3, Mei Sheng Duh, MPH, ScD3, Aljosja Rogiers, MD, PhD2, Haojie Li, PhD2;
1University Hospital Tübingen, Tübingen, Germany, 2Merck & Co., Inc., Rahway, NJ, USA, 3Analysis Group, Inc., Boston, MA, USA
1University Hospital Tübingen, Tübingen, Germany, 2Merck & Co., Inc., Rahway, NJ, USA, 3Analysis Group, Inc., Boston, MA, USA
OBJECTIVES: Patients with muscle-invasive bladder cancer (MIBC) continue to have a high recurrence risk, even following radical cystectomy (RC). Neoadjuvant cisplatin-based chemotherapy is recommended for cisplatin-eligible (cis-E) patients; however, approximately 50% of patients with MIBC are cisplatin-ineligible (cis-IE) and lack effective perioperative treatment alternatives. Clinical characteristics and perioperative treatment patterns for the cis-E and cis-IE MIBC subgroups are not well-understood.
METHODS: A panel-based, retrospective chart review (2010-2023) was conducted in France, Germany, and the United Kingdom, in MIBC patients (cT2-T4aN0M0 or cT1-T4aN1M0) planning to undergo RC. Cisplatin eligibility was determined using Galsky criteria: impaired renal function (CrCl <60 mL/min), ECOG performance status ≥2, NYHA class ≥III heart failure, audiometric hearing loss (CTCAE v5.0 grade ≥2), or peripheral neuropathy (CTCAE v5.0 grade ≥2). Clinical characteristics and treatment patterns were described and compared between cis-E and cis-IE cohorts using t-tests and chi-square tests.
RESULTS: Physicians (250 oncologists or urologists) abstracted 765 patient charts (340 cis-E and 425 cis-IE). Among cis-IE patients, the most common Galsky criteria for ineligibility were impaired renal function (62.6%) and ECOG performance status ≥2 (37.2%). Most patients underwent planned RC (94.6% cis-IE; 96.5% cis-E). Compared with cis-E patients, cis-IE patients were older (64.5 vs 61.9 years; p<0.001), had greater comorbidity burden (2.3 vs 1.2 select comorbidities; p<0.001), and higher rates of hypertension (48.5% vs 38.5%; p<0.01), hypercholesterolemia (26.4% vs 18.2%; p<0.01), and diabetes (22.6% vs 14.7%; p<0.01). Compared with cis-E patients, cis-IE patients were less likely to receive neoadjuvant therapy (21.2% vs 65.3%; p<0.001) and more likely to undergo surgery alone (without neoadjuvant or adjuvant therapies; 42.6% vs 20.3%; p<0.001).
CONCLUSIONS: Cis-IE patients were significantly older, had more comorbidities, and received fewer neoadjuvant therapies. These findings underscore the need for novel perioperative treatment options for this medically complex patient population.
METHODS: A panel-based, retrospective chart review (2010-2023) was conducted in France, Germany, and the United Kingdom, in MIBC patients (cT2-T4aN0M0 or cT1-T4aN1M0) planning to undergo RC. Cisplatin eligibility was determined using Galsky criteria: impaired renal function (CrCl <60 mL/min), ECOG performance status ≥2, NYHA class ≥III heart failure, audiometric hearing loss (CTCAE v5.0 grade ≥2), or peripheral neuropathy (CTCAE v5.0 grade ≥2). Clinical characteristics and treatment patterns were described and compared between cis-E and cis-IE cohorts using t-tests and chi-square tests.
RESULTS: Physicians (250 oncologists or urologists) abstracted 765 patient charts (340 cis-E and 425 cis-IE). Among cis-IE patients, the most common Galsky criteria for ineligibility were impaired renal function (62.6%) and ECOG performance status ≥2 (37.2%). Most patients underwent planned RC (94.6% cis-IE; 96.5% cis-E). Compared with cis-E patients, cis-IE patients were older (64.5 vs 61.9 years; p<0.001), had greater comorbidity burden (2.3 vs 1.2 select comorbidities; p<0.001), and higher rates of hypertension (48.5% vs 38.5%; p<0.01), hypercholesterolemia (26.4% vs 18.2%; p<0.01), and diabetes (22.6% vs 14.7%; p<0.01). Compared with cis-E patients, cis-IE patients were less likely to receive neoadjuvant therapy (21.2% vs 65.3%; p<0.001) and more likely to undergo surgery alone (without neoadjuvant or adjuvant therapies; 42.6% vs 20.3%; p<0.001).
CONCLUSIONS: Cis-IE patients were significantly older, had more comorbidities, and received fewer neoadjuvant therapies. These findings underscore the need for novel perioperative treatment options for this medically complex patient population.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EPH161
Topic
Epidemiology & Public Health
Topic Subcategory
Public Health
Disease
SDC: Oncology, SDC: Urinary/Kidney Disorders