美国一线全身抗癌治疗的局部晚期或转移性尿路上皮癌患者临床和经济结局的真实世界回顾性研究：IMPACT UC-III研究结果

Real-World Retrospective Study of Clinical and Economic Outcomes Among Patients with Locally Advanced or Metastatic Urothelial Carcinoma Treated with First-Line Systemic Anti-Cancer Therapies in the United States: Results from the IMPACT UC-III Study.

作者信息

Moon Helen H, Ike Chiemeka, Dixon Ruth W, Crowe Christopher L, Venkataraman Malvika, Morris Valerie, Kearney Mairead, Tonnu-Mihara Ivy, Barron John

机构信息

Kaiser Permanente Southern California, Riverside, CA 92505, USA.

EMD Serono, Inc., Boston, MA 02210, USA.

出版信息

Curr Oncol. 2025 Jul 2;32(7):384. doi: 10.3390/curroncol32070384.

DOI:10.3390/curroncol32070384

PMID:40710195

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12293318/

Abstract

This retrospective cohort study evaluated characteristics, treatment patterns, and clinical outcomes in adults with locally advanced/metastatic urothelial carcinoma (la/mUC) receiving first-line (1L) systemic treatment with or without avelumab 1L maintenance (1LM) between January 2020 and July 2023. The index date was the first date with a claim for 1L systemic therapy after a la/mUC diagnosis. Patients with continuous health plan enrollment for ≥6 months before and ≥1 month after the index date were identified from Carelon Research's Healthcare Integrated Research Database. Of 2820 patients receiving 1L treatment, 37.0% received platinum-based chemotherapy (PBC); 39.0%, immuno-oncology (IO) monotherapy; and 24.0%, other therapies. Renal disease and other comorbidities influenced 1L regimen choice. Healthcare resource utilization (HCRU) and costs were reported for patients receiving second-line (2L) treatment. HCRU was high in 32.8% of patients (926 of 2820) who received 2L treatment. Median all-cause direct medical costs per patient per month were USD 15,859, USD 19,781, USD 11,346, and USD 9516 for 1L PBC, 1L PBC + avelumab 1LM, 1L IO monotherapy, and 1L other therapies, respectively. Most direct healthcare costs were attributed to all-cause outpatient visits.

摘要

这项回顾性队列研究评估了2020年1月至2023年7月期间接受一线（1L）全身治疗且有或没有阿维鲁单抗1L维持治疗（1LM）的局部晚期/转移性尿路上皮癌（la/mUC）成人患者的特征、治疗模式和临床结局。索引日期为la/mUC诊断后首次提出1L全身治疗申请的日期。从Carelon Research的医疗保健综合研究数据库中识别出在索引日期之前连续参加健康计划≥6个月且在索引日期之后≥1个月的患者。在2820例接受1L治疗的患者中，37.0%接受了铂类化疗（PBC）；39.0%接受了免疫肿瘤学（IO）单药治疗；24.0%接受了其他治疗。肾脏疾病和其他合并症影响了1L治疗方案的选择。报告了接受二线（2L）治疗患者的医疗资源利用（HCRU）和费用。在接受2L治疗的患者中，32.8%（2820例中的926例）的HCRU较高。1L PBC、1L PBC +阿维鲁单抗1LM、1L IO单药治疗和1L其他治疗的每位患者每月全因直接医疗费用中位数分别为15,859美元、19,781美元、11,346美元和9516美元。大多数直接医疗费用归因于全因门诊就诊。