DRIVERS OF DECISIONS FOR FIRST-LINE (1L) TREATMENT IN METASTATIC UROTHELIAL CANCER (MUC): RESULTS FROM A REAL-WORLD SURVEY OF PHYSICIANS IN 5 EUROPEAN COUNTRIES
Author(s)
Mairead M. Kearney, MBA, MPH, MSc, MD1, Mia Unsworth, BSc2, Cameron Forshaw, MSc2, Maria Walley, MSc2, Hannah Wear, MSc2, Amber Simpson, BSc2, Alastair Hinds, BSc2, Imun Gill, MPharm3, Syed A. Hussain, MD4.
1Merck Healthcare KGaA, Darmstadt, Germany, 2Adelphi Real World, Bollington, United Kingdom, 3Merck Serono Ltd., an affiliate of Merck KGaA, Feltham, United Kingdom, 4Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield, Sheffield, United Kingdom.
1Merck Healthcare KGaA, Darmstadt, Germany, 2Adelphi Real World, Bollington, United Kingdom, 3Merck Serono Ltd., an affiliate of Merck KGaA, Feltham, United Kingdom, 4Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield, Sheffield, United Kingdom.
OBJECTIVES: Recent evolution of the mUC treatment landscape has increased the complexity of 1L treatment decision-making. This study assessed the factors that physicians consider when making 1L treatment decisions for patients with mUC.
METHODS: Data were drawn from the Adelphi Real World mUC Disease Specific Programme™, a cross-sectional survey of medical oncologists/urologists and their patients with mUC in France, Germany, Italy, Spain, and the UK from December 2023-July 2024. For this analysis, physicians who treat patients with mUC reported the 5 most important attributes driving 1L treatment choice from a predefined list. Country-level differences were evaluated using Fisher’s exact tests.
RESULTS: Of 238 physicians (France n=46, Germany n=50, Italy n=52, Spain n=49, UK n=41), 63% worked in an academic setting and 88% had treated patients with mUC for ≥5 years. Most commonly, physicians reported overall survival (OS) as an important attribute (84%) when informing 1L treatment decisions, with no statistically significant difference between countries (p=0.263). Progression-free survival (PFS) was reported by 70% of physicians, with significant differences between countries (p=0.039), ranging from 56% in the UK to 83% in France. Drivers involving impact on patients were chosen less frequently, with manageable side effect profiles selected by 37% of physicians, improving quality of life (QOL) by 19%, and improving pain by 3%, with no significant differences between countries (p=0.088, p=0.089, p=0.174, respectively).
CONCLUSIONS: Physicians across Europe most frequently prioritized OS and PFS when informing 1L treatment decisions for patients with mUC, with some country-level variation for PFS. Tolerability was considered by approximately one-third of physicians, while patient-centric factors such as QOL and symptom burden were less commonly factored into the initial treatment selection. These findings highlight possible gaps in shared decision-making and the need for greater consideration of patient perspectives, personal values and QOL when selecting 1L treatment for mUC.
METHODS: Data were drawn from the Adelphi Real World mUC Disease Specific Programme™, a cross-sectional survey of medical oncologists/urologists and their patients with mUC in France, Germany, Italy, Spain, and the UK from December 2023-July 2024. For this analysis, physicians who treat patients with mUC reported the 5 most important attributes driving 1L treatment choice from a predefined list. Country-level differences were evaluated using Fisher’s exact tests.
RESULTS: Of 238 physicians (France n=46, Germany n=50, Italy n=52, Spain n=49, UK n=41), 63% worked in an academic setting and 88% had treated patients with mUC for ≥5 years. Most commonly, physicians reported overall survival (OS) as an important attribute (84%) when informing 1L treatment decisions, with no statistically significant difference between countries (p=0.263). Progression-free survival (PFS) was reported by 70% of physicians, with significant differences between countries (p=0.039), ranging from 56% in the UK to 83% in France. Drivers involving impact on patients were chosen less frequently, with manageable side effect profiles selected by 37% of physicians, improving quality of life (QOL) by 19%, and improving pain by 3%, with no significant differences between countries (p=0.088, p=0.089, p=0.174, respectively).
CONCLUSIONS: Physicians across Europe most frequently prioritized OS and PFS when informing 1L treatment decisions for patients with mUC, with some country-level variation for PFS. Tolerability was considered by approximately one-third of physicians, while patient-centric factors such as QOL and symptom burden were less commonly factored into the initial treatment selection. These findings highlight possible gaps in shared decision-making and the need for greater consideration of patient perspectives, personal values and QOL when selecting 1L treatment for mUC.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
HSD13
Topic
Health Service Delivery & Process of Care
Disease
Oncology