Epidemiology, resource use, and treatment patterns of locally advanced or metastatic urothelial carcinoma in France

Describe real-world epidemiology, treatment patterns, health care resource utilization, and costs of locally advanced or metastatic urothelial carcinoma (la/mUC) in France. Retrospective study including all adults with la/mUC diagnosis during January 2017 to December 2020 in the PMSI database. Annual prevalence and incidence ranged from 36.4 to 38.9 and 16.4 to 18.5 cases per 100,000 people, respectively. Of the 25,314 patients with incident la/mUC, 37.6% did not receive first-line systemic treatment. Of the 14,656 patients who started first-line systemic treatment, 66.6%, 22.5%, and 10.9% received 1, 2, and 3 lines of therapy, respectively. Annual per-patient costs in second-/third-line setting ranged from €8803 to €16,012. The substantial disease burden of la/mUC in France highlights the unmet need for new therapies. <b>What is this article about?</b> Urothelial carcinoma (UC) is a type of cancer affecting the urinary system. It can spread to other parts of the body, described as locally advanced or metastatic (la/m). We used information from a French database recording hospitalizations in France to find out how many people have la/mUC, how many new cases develop each year, what treatments they receive, how many die in the hospital, and how much their care costs. <b>What were the results?</b> Based on database information, 37 to 39 of every 100,000 people have la/mUC and 17 to 19 of every 100,000 people are identified with a new case yearly. Slightly more than one-third of patients with la/mUC did not receive recommended treatment (chemotherapy) when first diagnosed. Chemotherapy was the most common treatment type for the first, second, or third treatment; checkpoint inhibitors (a unique treatment) became more commonly used as a second treatment over time. Yearly in-hospital death rates were high, ranging from 47.8% of patients who died within 1 year from diagnosis to 62.9% dying within 3 years. Yearly cost of care was high (costing €8803 to €16,012) in patients starting a second or third treatment. <b>What do the results of the study mean?</b> The study shows many patients may not be fit enough or choose not to receive treatment. Even those receiving treatment are at high risk for poor outcomes. The burden of la/mUC in France is high, underscoring the need for more therapies and better supportive care early in disease management.