| Sumario: | Simple Summary: In this study, we looked at medical records showing treatment patterns and outcomes in people with advanced urothelial cancer in the United States following the approval of avelumab for first-line maintenance treatment. Most people who completed first-line treatment received platinum-based chemotherapy (66%), and 89% of these people had no evidence of disease progression. Most people who went on to receive first-line maintenance received avelumab (62%). Outcomes with avelumab maintenance were similar to previous studies. Our study also demonstrates that, after disease progression on avelumab maintenance, second-line enfortumab vedotin appears to be an effective treatment option. Overall, available data support the use of avelumab maintenance as a standard treatment in people whose disease has not progressed following first-line platinum-based chemotherapy. Further research is needed to look at additional available treatment options and their associated outcomes when received outside of a clinical trial. Background: This study describes treatment patterns and clinical outcomes in patients with advanced urothelial carcinoma (aUC) in the US following the approval of avelumab for first-line maintenance treatment. Methods: This retrospective cohort study used deidentified patient data from the Tempus database. Eligible patients had completed first-line systemic anticancer treatment for aUC between July 2020 and March 2023. Results: In total, 974 eligible patients were identified; most (72%) were male. Median age at diagnosis was 70 years. Among patients who completed first-line platinum-based chemotherapy (644 [66%]), 574 (89%) had no evidence of disease progression. Of 219 patients who received first-line maintenance, 135 (62%) received avelumab. Median (95% CI) overall survival (OS) and progression-free survival (PFS) from avelumab maintenance start were 14.9 months (13.1—not estimable [NE) and 6.4 months (4.6—NE), respectively. Enfortumab vedotin (EV) was the most common second-line treatment after avelumab (70%). Median (95% CI) OS and PFS from second-line EV start were 11.6 months (6.1—NE) and 6.6 months (4.1—NE), respectively. Conclusions: Results provide insights into the impact of avelumab first-line maintenance treatment in patients with aUC in the US. Effectiveness data are consistent with previous findings, supporting the use of avelumab maintenance in patients without disease progression following first-line platinum-based chemotherapy. Second-line EV after progression on avelumab maintenance had similar effectiveness to results from other real-world studies.
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