OBJECTIVES:

The primary objective was to understand the treatment patterns of patients receiving 2L therapy for mUC in Spain.

METHODS:

This study was a retrospective, non-interventional study conducted using a panel of 50 Spanish physicians. Patient characteristics, treatment patterns, and outcomes data were collected from medical charts of the five most recent patients who began and stopped 2L mUC treatment. 2L was defined as treatment after progression/recurrence after 1L treatment, or recurrence with ≤12 months of neoadjuvant/adjuvant treatment. Analyses were conducted using descriptive statistics.

RESULTS:

Data were collected from 241 patients. Mean age at 2L treatment initiation was 63.5 (±9.04) years, and 81% were male. Initial urothelial cancer diagnosis was metastatic for 88% of patients, with the primary tumor site being urinary bladder (76%) and histology being transitional cell (80%). Most patients received platinum-based combination 1L treatment: gemcitabine + cisplatin (50%) and gemcitabine + carboplatin (24%). 60% of patients had complete or partial response to 1L treatment. At initiation of 2L treatment, 54% of patients had ECOG Grade 0 or 1. The most common 2L treatment was non-platinum-based monotherapy: vinflunine (41%) and paclitaxel (20%). At the end of 2L treatment, 29% of patients achieved a complete or partial response, 25% stable disease and 46% disease progression. Platinum-based treatments compared with non-platinum-based treatments were associated with significantly more hospital days for chemotherapy administration (p<.001) and more hospital days for monitoring/recovery (p=.002). Non-platinum-based treatments compared with platinum-based-treatments were associated with significantly shorter duration of time from end of 1L to start of 2L (p<.001), from the end of 2L to start of 3L (p=.005), and time on 2L treatment (p=.005). 10% of patients received third line treatment.

CONCLUSIONS:

In Spain, the most common 2L mUC treatment is non–platinum-based monotherapy. Poor 2L treatment outcomes indicate a high unmet need for these patients.