Real-World Clinical Outcomes with First-Line Systemic Treatment and Avelumab Maintenance in US Patients with Locally Advanced or Metastatic Urothelial Carcinoma: The SPEAR Bladder-II Study
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View abstract on PubMed
Summary
This summary is machine-generated.This study examined real-world treatment patterns for advanced urothelial carcinoma. Avelumab first-line maintenance (1LM) showed promising overall survival (OS) in patients progressing after platinum-based chemotherapy (PBC).
Area Of Science
- Oncology
- Urothelial Carcinoma Research
- Immunotherapy Outcomes
Background
- Avelumab first-line maintenance (1LM) is approved for locally advanced or metastatic urothelial carcinoma (la/mUC) post-platinum-based chemotherapy (PBC).
- Understanding real-world treatment patterns and outcomes is crucial for optimizing patient care in la/mUC.
- This study analyzes data from a large US community oncology electronic health records database.
Purpose Of The Study
- To describe real-world treatment patterns in patients with la/mUC initiating first-line (1L) systemic therapy.
- To evaluate clinical outcomes, including overall survival (OS), associated with different 1L treatments and subsequent therapies.
- To assess the effectiveness of avelumab 1LM and subsequent enfortumab vedotin (EV) in a real-world setting.
Main Methods
- Retrospective analysis of 1658 patients with la/mUC initiating 1L treatment between December 2019 and November 2023.
- Data extracted from the iKnowMed electronic health records database.
- Analysis of treatment sequences, including immuno-oncology (IO) monotherapy, PBC only, and avelumab 1LM, and their associated OS.
Main Results
- 1L treatment included IO monotherapy (41.2%), PBC only (32.4%), and avelumab 1LM after PBC (11.2%).
- Median OS from 1L start was 20.4 months for cisplatin-based only, 11.0 months for carboplatin-based only, and 14.6 months for IO monotherapy.
- Median OS from avelumab 1LM start was 18.5 months. Following avelumab 1LM discontinuation, 43.5% received 2L therapy, with 59.3% receiving enfortumab vedotin (EV).
Conclusions
- Real-world treatment patterns in la/mUC show diverse 1L strategies, with a notable proportion receiving IO monotherapy.
- Avelumab 1LM demonstrates a median OS of 18.5 months, aligning with clinical trial data.
- Subsequent treatment with enfortumab vedotin after avelumab 1LM shows promising outcomes, supporting its role in later lines of therapy.
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