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

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.