PD36-09 TIME TRENDS IN SYSTEMIC TREATMENTS AND SURVIVAL IN PATIENTS WITH METASTATIC UROTHELIAL BLADDER CANCER: OUTCOMES IN THE ERA OF IMMUNOTHERAPY

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You have accessJournal of UrologyCME1 Apr 2023PD36-09 TIME TRENDS IN SYSTEMIC TREATMENTS AND SURVIVAL IN PATIENTS WITH METASTATIC UROTHELIAL BLADDER CANCER: OUTCOMES IN THE ERA OF IMMUNOTHERAPY Harshit Garg, Mukund Bhandari, Monica Sridhar, Onika Noel, Furkan Dursun, Michael Liss, Dharam Kaushik, Robert Svatek, Chethan Ramamurthy, and Ahmed Mansour Harshit GargHarshit Garg More articles by this author , Mukund BhandariMukund Bhandari More articles by this author , Monica SridharMonica Sridhar More articles by this author , Onika NoelOnika Noel More articles by this author , Furkan DursunFurkan Dursun More articles by this author , Michael LissMichael Liss More articles by this author , Dharam KaushikDharam Kaushik More articles by this author , Robert SvatekRobert Svatek More articles by this author , Chethan RamamurthyChethan Ramamurthy More articles by this author , and Ahmed MansourAhmed Mansour More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003334.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The management of metastatic urothelial carcinoma of the urinary bladder has been revolutionized with the advent of immune-checkpoint inhibitors (ICI). However, the survival outcomes in metastatic bladder cancer over the past decade with improvements in systemic therapies have not been studied. The aim of the study is to investigate the time trends in treatment strategies and overall survival (OS) in patients with metastatic urothelial cancer of the bladder. METHODS: Using the recently updated National Cancer Database, patients with newly diagnosed metastatic urothelial cancer of the urinary bladder between 2014-2019 were included. We analyzed changes in the first-line systemic treatment and the changes in the 1-year OS using cox multivariable regression and Kaplan Meier analysis. The OS analysis was censored at 1-year to account for possible bias due to shorter follow-up in most recent years. RESULTS: Overall, 10,965 patients met the inclusion criteria with 9,229 receiving systemic chemotherapy and 1,666 patients receiving systemic immunotherapy. The use of immunotherapy increased from 2.3% (9/391) in 2007 to 36.5% (484/1325) to 2019 (p<0.001) and the use of systemic chemotherapy decreased from 98.2% (270/275) in 2004 to 63.5% (841/1325) in 2019 (p<0.001). (Figure 1a). The median and 1-year OS of the entire cohort increased from 9.9 months and 38.6% in 2004 to 12.5 months and 50.8% in 2018 respectively (p<0.001) (Figure 1b). From 2009 to 2018, the 1-y OS improved gradually from 38.3% to 53.6% in systemic chemotherapy and 44.4% to 46.3% in the systemic immunotherapy group. (Figure 1c) The improvement in systemic chemotherapy arm could be potentially attributed to increased use of second line immunotherapy in this cohort. CONCLUSIONS: The use of immunotherapy as first-line therapy has substantially increased over the past years. The median OS in metastatic bladder cancer has also improved over the past 15 years, possibly because of the advent of immune-checkpoint therapy. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e983 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Harshit Garg More articles by this author Mukund Bhandari More articles by this author Monica Sridhar More articles by this author Onika Noel More articles by this author Furkan Dursun More articles by this author Michael Liss More articles by this author Dharam Kaushik More articles by this author Robert Svatek More articles by this author Chethan Ramamurthy More articles by this author Ahmed Mansour More articles by this author Expand All Advertisement PDF downloadLoading ...