Evaluating Oncologists' Practice Patterns and Decision-Making in Locally Advanced or Metastatic Urothelial Carcinoma: The US Physician PARADIGM Study.

Autor:	Gupta S; Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic Foundation, Cleveland, OH, USA., Costantino H; Cerner Enviza, an Oracle company, Kansas City, MO, USA., Ike C; EMD Serono, Inc., Rockland, MA, USA, an affiliate of Merck KGaA., Gupta S; Cerner Enviza, an Oracle company, Kansas City, MO, USA., Bhanegaonkar A; EMD Serono, Inc., Rockland, MA, USA, an affiliate of Merck KGaA., Su C; Cerner Enviza, an Oracle company, Kansas City, MO, USA., Thakkar S; Pfizer, New York, NY, USA., Mackie DS; Cerner Enviza, an Oracle company, Kansas City, MO, USA., Devgan G; Pfizer, New York, NY, USA., Katzenstein HM; EMD Serono, Inc., Rockland, MA, USA, an affiliate of Merck KGaA., Liu FX; EMD Serono, Inc., Rockland, MA, USA, an affiliate of Merck KGaA.
Jazyk:	angličtina
Zdroj:	The oncologist [Oncologist] 2024 Mar 04; Vol. 29 (3), pp. 244-253.
DOI:	10.1093/oncolo/oyad267
Abstrakt:	Background: The treatment landscape for locally advanced/metastatic urothelial carcinoma (la/mUC) has evolved. This study examined US prescribing patterns and clinical decision-making for first-line (1L) and first-line maintenance (1LM) treatment. Materials and Methods: US-based oncologists (N = 150) completed an online survey on patient demographics, practice patterns, and important factors considered in 1L/1LM selection. Multivariable logistic regression was used to assess factors associated with more vs less frequent 1L/1LM prescribing. Results: Physician reports estimated that 23% of patients with la/mUC had not received any systemic therapy in the previous 6 months; however, 46% received 1L, 32% received second-line, and 22% received subsequent-line systemic treatments. Of patients who were receiving 1L treatment, 72% were estimated to be receiving 1L platinum-based chemotherapy. Around 69% of patients eligible for 1LM received the treatment. Physicians categorized as frequent prescribers reported overall survival (OS), disease control rate (DCR), and rate of grade 3/4 adverse events (AEs) as factors associated with 1L treatment selection (all P < .05). OS, rate of grade 3/4 immune-mediated AEs, and inclusion in institutional guidelines were reported as attributes used in 1LM treatment selection (all P < .05). Multivariable analysis revealed OS, DCR, and rate of grade 3/4 AEs as important factors in oncologists' 1L treatment selection; academic practice setting and use of Response Evaluation Criteria in Solid Tumors version 1.1 were associated with 1LM use (all P < .05). Conclusion: OS and AEs were found to be relevant factors associated with offering 1L and 1LM treatment. Variability exists in physicians' decision-making in the real-world setting for la/mUC. (© The Author(s) 2023. Published by Oxford University Press.)
Databáze:	MEDLINE
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