Approaches to Immune Checkpoint Inhibitor (ICI) First-Line Maintenance Therapy (1L-MT) in Unresectable Locally Advanced (LA) or Metastatic Urothelial Cancer (mUC) in France, Germany, Italy, Spain, and the UK (EU5)
Author(s)
Milloy N1, Berry M2, Kostikas M2, Li S3, Kearney M4, Bharmal M5, Costa N6, Chang J3
1Adelphi Real World, LONDON, LON, UK, 2Adelphi Real World, Bollington, UK, 3Pfizer, New York, NY, USA, 4the healthcare business of Merck KGaA, Darmstadt, Germany, 5EMD Serono, Billerica, MA, USA, 6Pfizer, Porto Salvo, Portugal
Presentation Documents
OBJECTIVES: Avelumab was approved for 1L-MT following disease control with platinum-based chemotherapy in patients with LA/mUC in the EU (January 2021). This survey aimed to understand how EU physicians might incorporate this novel treatment approach into clinical practice. METHODS: Real-world data were drawn from the Adelphi Metastatic Urothelial Cancer Disease-Specific ProgrammeTM, – a cross-sectional survey conducted November 2020-April 2021 among oncologists/urologists across EU5. Physicians completed a quantitative survey capturing demographics, workload, treatment use, and perspectives about the use of 1L-MT. Summary statistics were reported and descriptively analysed. RESULTS: In total, 232 physicians (87.5% oncologists, 31.5% female, 59.5% qualified >15 years ago, and 57.7% in public hospital practice) provided data. A mean of 33 (SD, 28) patients with LA/mUC are currently managed by physicians. On average, physicians estimated 83.5% of their patients are platinum eligible. A majority of physicians (63.4%) determine cisplatin or platinum eligibility based on a formal detailed assessment of the patient’s condition. Familiarity among physicians with 1L-MT with ICIs in mUC was high (79%; 183/232), ranging from 73% in Italy to 86% in France. Among the 183 physicians, 142 (77.6%) would use 1L-MT in eligible patients; 22.4% would not. For those who would use 1L-MT, 88.7% would use after 4-6 cycles of 1L chemotherapy (11.3%, <4 cycles); 79 (55.6%) physicians would start 1L-MT 4-6 weeks following disease control and stopping 1L chemotherapy (24.6%, <4 weeks; 16.9%, >6 weeks; 2.8% vary by patient or time). CONCLUSIONS: Despite avelumab only recently being approved, most EU physicians surveyed are familiar with 1L-MT and the majority would use it in eligible patients after 4-6 cycles of chemotherapy with a treatment break of 4-6 weeks. Further real-world research is needed to investigate how physicians’ perception and practice patterns will evolve with newer guideline recommendations and growing use and experience with avelumab 1L-MT in LA/mUC.
Conference/Value in Health Info
2021-11, ISPOR Europe 2021, Copenhagen, Denmark
Value in Health, Volume 24, Issue 12, S2 (December 2021)
Code
POSA243
Topic
Health Service Delivery & Process of Care, Real World Data & Information Systems
Topic Subcategory
Health & Insurance Records Systems, Prescribing Behavior
Disease
Oncology, Urinary/Kidney Disorders