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. 2025 Mar;21(6):665-679.
doi: 10.1080/14796694.2025.2459058. Epub 2025 Feb 20.

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

Florence Joly  1   2   3 , Stephane Culine  4   5 , Morgan Roupret  6 , Aurore Tricotel  7 , Emilie Casarotto  7 , Sandrine Brice  7 , Rafael Minacori  8 , Marthe Vuillet  8 , Marie-Catherine Thomas  8 , Kirsten Leyland  9 , Anil Upadhyay  9 , Vicki Munro  9 , Torsten Strunz-McKendry  9
Affiliations

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

Florence Joly et al. Future Oncol. 2025 Mar.

Abstract

Aim: Describe real-world epidemiology, treatment patterns, health care resource utilization, and costs of locally advanced or metastatic urothelial carcinoma (la/mUC) in France.

Patients & methods: Retrospective study including all adults with la/mUC diagnosis during January 2017 to December 2020 in the PMSI database.

Results: 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.

Conclusion: The substantial disease burden of la/mUC in France highlights the unmet need for new therapies.

Keywords: France; Incidence; costs; prevalence; treatment; urothelial carcinoma.

Plain language summary

What is this article about?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.What were the results?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.What do the results of the study mean?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.

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Conflict of interest statement

Florence Joly reports consulting fees from GSK; payment or honoraria for lectures and presentations (symposium) from 3A, Amgen, Astellas, AstraZeneca, GSK, Ipsen, MSD/ESAI, and Pfizer; support for attending meetings and/or travel from GSK, Ipsen, MSD/ESAI, and Pfizer; participating on an Advisory Board for AstraZeneca, Bayer, GSK, Ipsen, MSD/ESAI, and Pfizer; as well as an unpaid leadership or fiduciary role for GCIG. Stephane Culine reports consulting fees from Bayer; payment or honoraria from AstraZeneca, Ipsen, Janssen, Merck, MSD, and Takeda; support for attending meetings and/or travel from Janssen; and participating on a Data Safety Monitoring Board or Advisory Board for Amgen and BMS. Morgan Roupret reports consulting fees from Astellas, Bayer, BMS, Ipsen, and Janssen. Aurore Tricotel, Emilie Casarotto, and Sandrine Brice are employees of IQVIA, contracted by Astellas Pharma Inc. to conduct the study. Rafael Minacori, Marthe Vuillet, and Marie-Catherine Thomas are employees of Astellas Pharma France. Kirsten Leyland, Anil Upadhyay, Vicki Munro, and Torsten Strunz-McKendry are employees of Astellas Pharma Europe Ltd. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Medical writing support was provided by Catherine Mirvis, BA, and Beth Lesher, PharmD, BCPS, from OPEN Health and was funded by Astellas Pharma Inc. and Pfizer.

Figures

None
Graphical abstract
Figure 1.
Figure 1.
Study design. aFor population 1, which includes patients with la/mUC diagnosed before and during the inclusion period, the index date was defined depending on patient status at the start of the inclusion period. For prevalent patients (ie, those diagnosed before 2017), the index date was 1 January 2017. For incident patients (ie, those newly diagnosed on or after 1 January 2017), the index date was the date of first la/mUC diagnosis.
Figure 2.
Figure 2.
Study population.
Figure 3.
Figure 3.
Therapeutic pathways for patients newly diagnosed with la/mUC between 2017 and 2019.
Figure 4.
Figure 4.
Flow diagram of select stays for health care resource utilization and health care cost analysis (population 3).
See this image and copyright information in PMC

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