Nimira Alimohamed, MD, Princess Margaret Cancer Centre, Toronto, ON, discusses results from a real-world analysis evaluating survival outcomes over time in patients with muscle-invasive bladder cancer (MIBC) and patients with metastatic urothelial carcinoma (mUC).
This study was presented at the virtual 2021 ASCO Genitourinary Cancers Symposium.
We evaluated trends over time in survival in patients with urothelial carcinoma in the real world. This was a multicenter analysis, which was presented at the recent GU ASCO symposium, just last weekend.
The purpose of the study was to take a look at the real‑world data to evaluate how are patients with urothelial carcinoma doing in terms of survival over time. Over the last 15 to 20 years, have we seen any significant improvements?
We evaluated two groups of patients, so patients with muscle invasive bladder cancer and those with metastatic disease. We've broken them into two‑time periods. The first‑time period evaluated was from 2005 until 2011, and the second‑time period was 2012 to 2018.
Data was collected from our centers here in Alberta, so all of Alberta Health Services as well as the Princess Margaret Cancer Center in Ontario. Overall, we evaluated patient data on over 572 patients. What we found is that outcomes for patients with muscle invasive disease have significantly improved over time, both in terms of overall survival and progression‑free survival.
In time period one, patients with muscle invasive disease—again, reminded that these are treated with curative intent—their overall survival was 34 months approximately compared to 83 months in time period two. That was statistically significant. Similar improvements were seen in progression‑free survival.
Some thoughts behind that are that we have seen major improvements in terms of perioperative treatments. We are using a lot more neoadjuvant chemotherapy from time period two onwards, as well as surgical outcomes have improved, and we know that from other data.
I think our real‑world data highlights what we had hoped to see in terms of keeping with improvements in chemotherapy, improvements in surgical techniques, technologies, and standardization of surgical practices. That was exciting to see and to confirm that in patients with muscle invasive disease.
The second group was patients with metastatic urothelial carcinoma. The median overall survival in time period one was 9.4 months, and then time period two was 10.5 months. This was not a significant improvement. This is also in keeping with what we see in our clinics and our practices every day.
Really, the times that we studied were until the end of 2018. What we hope to see in the future is that further analyses will highlight the benefit of new treatments in the metastatic setting, which have been implemented in 2018 onwards, notably with second‑line immunotherapy becoming the standard of care and novel other therapies being introduced in later lines of care.
Overall, this study, done from 572 patients in the real world, a multicenter analysis, brought to light and documented that we have seen improvements over time in patients with muscle invasive disease. We're still awaiting those improvements in patients with metastatic urothelial cancer.
This is still a serious disease, and there's lots of room to improve on still in terms of outcomes for our patients. Thank you for having me.
Samnani S, Veitch ZW, Kaiser J, et al. Trends over time in survival in patients with urothelial carcinoma in the real-world: A multicenter analysis. Presented at: the virtual 2021 ASCO Genitourinary Cancers Symposium; February 11-13, 2021. Abstract 412.
Dr Alimohamed reports no relevant financial relationships.