REAL-WORLD STUDY OF UPTAKE OF ENFORTUMAB VEDOTIN (EV) IN FIRST-LINE (1L) TREATMENT OF LOCALLY ADVANCED/METASTATIC UROTHELIAL CANCER (LA/MUC) IN THE US
Author(s)
David M. Gill, MD1, David Nimke, DrPH, MPH2, Robert Snijder, MSc3, Allison Thompson, PhD, MBA4, Dharanija Rao, PhD5, Christina M. Quicquaro, PharmD, MSHI2.
1Intermountain Health, Salt Lake City, UT, USA, 2Astellas Pharma Global Development, Northbrook, IL, USA, 3Astellas Pharma Europe B.V, Leiden, Netherlands, 4Pfizer Inc., Bothell, WA, USA, 5Pfizer Inc., New York, NY, USA.
1Intermountain Health, Salt Lake City, UT, USA, 2Astellas Pharma Global Development, Northbrook, IL, USA, 3Astellas Pharma Europe B.V, Leiden, Netherlands, 4Pfizer Inc., Bothell, WA, USA, 5Pfizer Inc., New York, NY, USA.
OBJECTIVES: EV monotherapy received accelerated approval in December 2019 and full approval from the US FDA in July 2021 for patients with la/mUC who had previously received both a PD-1/PD-L1 inhibitor (PD-[L]1i) and platinum-based chemotherapy (PBC). EV plus pembrolizumab (EV+P) received accelerated approval in April 2023 as 1L treatment for cisplatin-ineligible patients with la/mUC and full approval in December 2023 as 1L treatment for la/mUC. The objective of this study was to describe 1L utilization of EV-containing regimens over time in US patients with la/mUC.
METHODS: This non-interventional cohort study identified patients in the US initiating 1L treatment for la/mUC from 1-Jan-2022 through 30-Sep-2024 from the IQVIA Closed Claims Database using claims-based algorithms. Patient characteristics were measured during the year prior to/at the index date (the date first-line treatment was initiated). The overall distribution of 1L regimens was reported by quarter from Q1-2022 to Q3-2024; individual patients were not tracked over time.
RESULTS: 3,018 eligible patients were identified; median age (interquartile range) at index was 68 (61-77) years and 25.1% were female. 1L la/mUC treatments included EV-containing regimens (n=377 [12.5%]); PD-[L]1i monotherapy (n=835 [27.7%]); PBC without concomitant PD-(L)1i (n=1,134 [37.6%]); PBC with concomitant PD-(L)1i (n=40 [1.3%]); and other regimens (n=632 [20.9%]). There was a consistent increase in the uptake of EV-containing regimens from Q1-2022 to Q3-2024 (0.7% to 31.8%) and a relative decline in the use of PD-(L)1i monotherapy (35.7% to 13.7%) and PBC without concomitant PD-(L)1i (46.8% to 27.5%). The use of PBC with concomitant PD-(L)1i remained low (0.3-2.4%) and stable over time. Trends for specific subgroups (age, prior peripheral neuropathy, metastatic burden) were largely similar with those observed for the overall population.
CONCLUSIONS: This study showed a consistent increase in the use of EV‑containing regimens as 1L treatment over time, alongside declining use of PD‑(L)1i monotherapy and PBC without concomitant PD‑(L)1i.
METHODS: This non-interventional cohort study identified patients in the US initiating 1L treatment for la/mUC from 1-Jan-2022 through 30-Sep-2024 from the IQVIA Closed Claims Database using claims-based algorithms. Patient characteristics were measured during the year prior to/at the index date (the date first-line treatment was initiated). The overall distribution of 1L regimens was reported by quarter from Q1-2022 to Q3-2024; individual patients were not tracked over time.
RESULTS: 3,018 eligible patients were identified; median age (interquartile range) at index was 68 (61-77) years and 25.1% were female. 1L la/mUC treatments included EV-containing regimens (n=377 [12.5%]); PD-[L]1i monotherapy (n=835 [27.7%]); PBC without concomitant PD-(L)1i (n=1,134 [37.6%]); PBC with concomitant PD-(L)1i (n=40 [1.3%]); and other regimens (n=632 [20.9%]). There was a consistent increase in the uptake of EV-containing regimens from Q1-2022 to Q3-2024 (0.7% to 31.8%) and a relative decline in the use of PD-(L)1i monotherapy (35.7% to 13.7%) and PBC without concomitant PD-(L)1i (46.8% to 27.5%). The use of PBC with concomitant PD-(L)1i remained low (0.3-2.4%) and stable over time. Trends for specific subgroups (age, prior peripheral neuropathy, metastatic burden) were largely similar with those observed for the overall population.
CONCLUSIONS: This study showed a consistent increase in the use of EV‑containing regimens as 1L treatment over time, alongside declining use of PD‑(L)1i monotherapy and PBC without concomitant PD‑(L)1i.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
SA94
Topic
Health Service Delivery & Process of Care, Real World Data & Information Systems, Study Approaches
Disease
Oncology