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. 2024 Jul;31(7):730-738.
doi: 10.1111/iju.15450. Epub 2024 Mar 12.

Real-world epidemiology and treatment patterns of patients with locally advanced or metastatic urothelial carcinoma: Retrospective analysis of Diagnosis Procedure Combination claims data in Japan

Keiko Asakawa  1 , Miina Waratani  1 , Olivia Massey  2 , Tim Holbrook  2 , Makoto Kondo  1 , Atsushi Saito  1 , Hiroyuki Nishiyama  3
Affiliations

Real-world epidemiology and treatment patterns of patients with locally advanced or metastatic urothelial carcinoma: Retrospective analysis of Diagnosis Procedure Combination claims data in Japan

Keiko Asakawa et al. Int J Urol. 2024 Jul.

Abstract

Objectives: Evaluate real-world epidemiologic trends and treatment patterns in newly diagnosed patients with locally advanced or metastatic urothelial carcinoma (la/mUC) in Japan.

Methods: This retrospective analysis included adults with newly diagnosed la/mUC in Japan (January 2015-December 2019) from a nationwide-linked electronic medical record Diagnostic Procedure Combination claims dataset. Outcomes included epidemiologic trends (incidence and prevalence), baseline demographics, clinical characteristics, and treatment patterns in newly diagnosed patients with la/mUC before (2015-2017) and after (2018-2019) approval of pembrolizumab in Japan.

Results: Of 975 patients included, 76.4% were men; 71.6% were aged 70 years or older. Most cases (70.5%) were of the bladder. Between 2015 and 2019, the annual age-adjusted incidence increased from 6.8 to 12.4 per 100 000; the annual age-adjusted period prevalence increased from 13.0 to 25.2 per 100 000; and 307 (31.5%) and 668 (68.5%) patients were diagnosed from 2015 to 2017 and 2018 to 2019, respectively. Overall, 731 (75%) patients received systemic anticancer therapy; all received 1 line and 50.2% received 2 lines of therapy; 78.3% of patients received gemcitabine plus platinum-based therapy and 2.2% received pembrolizumab as first-line treatment. First-line treatment rates increased from 69.4% to 77.5% after pembrolizumab approval. Of 367 patients who received second-line treatment, 22.3% received gemcitabine plus platinum-based therapy; 14.7% received pembrolizumab.

Conclusions: In the Japanese regions considered, incidence and prevalence of newly diagnosed la/mUC increased over time and first-line treatment with pembrolizumab increased after approval.

Keywords: Japan; epidemiology; locally advanced/ metastatic urothelial carcinoma; real‐world; retrospective analysis; treatment patterns.

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Conflict of interest statement

Keiko Asakawa is an employee of Astellas Pharma, Inc., and declares no other conflict of interest. Miina Waratani is an employee of Astellas Pharma, Inc., and declares no other conflict of interest. Olivia Massey reports that employer, Adelphi Real World, received funding from Astellas Pharma, Inc., to design and conduct the study. Tim Holbrook has nothing to report. Makoto Kondo has nothing to report. Atsushi Saito is an employee of Astellas Pharma, Inc., and declares no other conflict of interest. Hiroyuki Nishiyama reports grants from Astellas Pharma, Inc., Ono Pharmaceutical, Takeda Pharmaceutical, and Bayer; and reports payment or honoraria for speakers bureaus from MSD, Chugai Pharmaceutical, and Olympus.

Figures

FIGURE 1
FIGURE 1
(a) Study design and (b) study population algorithm for patient volunteers with newly diagnosed locally advanced or mUC. (b) Multiple criteria are employed for steps 4 and 5 of deriving the patient cohort (e.g., to avoid biasing the population treated for mUC). ICD‐10, International Classification of Diseases, Tenth Revision; MEDIS‐DC, Medical Information System Development Center; mUC, metastatic urothelial carcinoma; UC, urothelial carcinoma.
FIGURE 2
FIGURE 2
Composition of study patients with newly diagnosed locally advanced or mUC. mUC, metastatic urothelial carcinoma.
FIGURE 3
FIGURE 3
Age‐adjusted incidence over time of newly diagnosed locally advanced or mUC 2015–2019. mUC, metastatic urothelial carcinoma.
FIGURE 4
FIGURE 4
Region‐adjusted incidence over time of newly diagnosed locally advanced or mUC 2015–2019. mUC, metastatic urothelial carcinoma.
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