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2019 ASCO Annual Meeting!

Session: Genitourinary (Nonprostate) Cancer

Type: Poster Session

Time: Monday June 3, 1:15 PM to 4:15 PM

Location: Hall A

Treatment (tx) characteristics of patients (pts) with locally advanced or metastatic urothelial cancer (mUC) receiving checkpoint inhibitor (CPI) monotherapy in a US clinical practice.

Bladder Cancer

Genitourinary (Nonprostate) Cancer

2019 ASCO Annual Meeting

Abstract No:

Poster Board Number:
Poster Session (Board #352)

J Clin Oncol 37, 2019 (suppl; abstr 4526)

Author(s): Alicia K. Morgans, Osama E. Rahma, Shivani K. Mhatre, Ching-Yi Chuo, Jessica Davies, Jorge Martinalbo, Nicole N. Davarpanah, Russell Pachynski; Northwestern University, Chicago, IL; Dana-Farber Cancer Institute, Boston, MA; Genentech, Inc., South San Francisco, CA; Roche Products, Ltd., Welwyn Garden City, United Kingdom; F. Hoffmann-La Roche, Ltd, Basel, Switzerland; Division of Oncology, Washington University Medical School, St. Louis, MO

Abstract Disclosures


Background: Approval of anti–PD-L1/anti–PD-1 CPI agents has changed the mUC tx landscape, but real-world (RW) tx patterns are not well described. Here, we describe pt characteristics, time on tx (TOT), tx-cycle distribution, relative dose intensity (RDI) and subsequent tx for pts receiving atezolizumab (atezo), nivolumab (nivo) or pembrolizumab (pembro) monotherapy. Methods: Pts diagnosed with mUC who completed atezo, nivo or pembro in the first-line (1L) or prior-platinum second-line and beyond (2L+) settings by April 30, 2018, were identified from the US-based Flatiron Health electronic health record–derived database. TOT was defined as time from first to last CPI administration + 1 cycle, tx cycles as number of CPI doses received during TOT and RDI as ratio of actual to planned dose per week to reflect any dose interruption. Results: RW data from pts receiving atezo, nivo and pembro were analyzed (Table). Up to 38% of pts had ECOG PS > 1. Median TOT ranged from 2.1-2.8 mo, with overlapping 95% CIs; mean TOT ranged from 2.7-4.1 mo. Over 50% of pts had ≤ 4 tx cycles. 21%-38% of pts did not have RDI within 95%-105% of the labeled dose. Most common subsequent txs were platinum-based chemotherapy combinations with gemcitabine or taxanes (post–1L CPI) and taxane monotherapy or other CPI monotherapy/combinations (post–2L+ CPI). Conclusions: Here, we present the largest analysis of RW CPI use in mUC to date. Overall, this unadjusted descriptive analysis showed relative comparability of pt and tx characteristics and TOT across CPI-treated groups. Insights into RW tx allow for an understanding of how clinical trial data translate to broader pt populations, including those with ECOG PS > 1, and may be useful for practitioners.

Atezo, 1LaAtezo, 2L+Nivo, 2L+Pembro, 1LaPembro, 2L+
≥ 65 years, %8684698878
ECOG PS > 1, %b381963320
Median TOT, mo (95% CI)2.1 (0.7, 4.2)2.8 (1.4, 4.9)2.0 (1.2, 3.6)2.8 (1.4, 3.8)2.7 (1.4, 3.5)
Mean TOT, mo (SD)2.9 (2.9)4.0 (3.8)2.7 (2.1)2.9 (1.9)2.9 (1.8)
> 4 tx cycles, %3543494130
95%-105% RDI, %7679626870

a Unknown cisplatin eligibility and prior (neo)adjuvant platinum use. b % based on pts with known ECOG PS.

Other Abstracts in this Sub-Category:


1. CALGB 90601 (Alliance): Randomized, double-blind, placebo-controlled phase III trial comparing gemcitabine and cisplatin with bevacizumab or placebo in patients with metastatic urothelial carcinoma.

Meeting: 2019 ASCO Annual Meeting Abstract No: 4503 First Author: Jonathan E. Rosenberg
Category: Genitourinary (Nonprostate) Cancer - Bladder Cancer


2. Randomized double-blind phase II study of maintenance pembrolizumab versus placebo after first-line chemotherapy in patients (pts) with metastatic urothelial cancer (mUC): HCRN GU14-182.

Meeting: 2019 ASCO Annual Meeting Abstract No: 4504 First Author: Matt D. Galsky
Category: Genitourinary (Nonprostate) Cancer - Bladder Cancer


3. EV-201: Results of enfortumab vedotin monotherapy for locally advanced or metastatic urothelial cancer previously treated with platinum and immune checkpoint inhibitors.

Meeting: 2019 ASCO Annual Meeting Abstract No: LBA4505 First Author: Daniel Peter Petrylak
Category: Genitourinary (Nonprostate) Cancer - Bladder Cancer