Mp71-11 Real-World Treatments Following Bacillus Calmette-Guérin Induction in Patients With Non-Muscle Invasive Bladder Cancer: A Contemporary Us Claims Analysis

You have accessJournal of UrologyBladder Cancer: Non-invasive IV (MP71)1 May 2024MP71-11 REAL-WORLD TREATMENTS FOLLOWING BACILLUS CALMETTE-GUÉRIN INDUCTION IN PATIENTS WITH NON-MUSCLE INVASIVE BLADDER CANCER: A CONTEMPORARY US CLAIMS ANALYSIS Min Yang, Mirko Fillbrunn, Hesen Li, Adina Zhang, Ashton Moradi, Amy Guo, and Ashish M. Kamat Min YangMin Yang , Mirko FillbrunnMirko Fillbrunn , Hesen LiHesen Li , Adina ZhangAdina Zhang , Ashton MoradiAshton Moradi , Amy GuoAmy Guo , and Ashish M. KamatAshish M. Kamat View All Author Informationhttps://doi.org/10.1097/01.JU.0001009548.76580.ba.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: There has been a recent surge in clinical trials focused on patients who have recurrent disease of their non-muscle invasive bladder cancer (NMIBC) after Bacillus Calmette-Guérin (BCG). Due to ongoing BCG shortages and access to alternative agents, the true number of patients who are receiving BCG induction is unclear. Herein, we evaluated this question and elucidated alternative treatment agents that patients received among a contemporary US insurance claims database. METHODS: From the Komodo Health claims database (1/2018-3/2023) with∼320 million Medicare Advantage, Medicaid, Managed Medicaid, and commercial patients, we identified NMIBC patients using the following algorithm: a) presence of carcinoma in-situ (CIS), or b) presence of bladder cancer (BC) and TURBT, followed by intravesical chemotherapy or immunotherapy or 12-months with no treatment and no evidence of muscle-invasive BC. Patients were further queried to identify those who received adequate BCG induction (i.e., ≥5 weekly instillations). We summarized the distribution of this group and the treatments following BCG induction with ≥12 months of evaluable data for the overall population and the CIS subgroup. RESULTS: Of 6,981 NMIBC patients receiving BCG, more than half (4,504, 64.5%) had adequate BCG induction; of these patients, 3,163 had ≥12 months data (including 28.7% CIS patients). Following adequate BCG induction, 49.7% had further BCG with 24.9% having ≥2 doses of maintenance BCG; 38.9% had no further treatment, and 11.4% (362 patients) were treated with other therapies – including gemcitabine (29.0%), mitomycin C (20.7%), radical cystectomy (14.1%), BCG+interferon alpha (11.0%), radiotherapy (8.6%), and pembrolizumab (5.5%). A similar distribution was observed in the CIS subgroup though BCG+interferon alpha was the second most common treatment (Table 1). CONCLUSIONS: In this analysis, we found that more than half of NMIBC patients treated with BCG received an adequate BCG induction but only one-quarter received maintenance BCG. Among patients who received other therapies after induction, gemcitabine and mitomycin C remain to be most commonly used. These patterns have implications not only for patient care, but especially for clinical trial design and enrollment. Source of Funding: Ferring Pharmaceuticals, Inc © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1164 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Min Yang More articles by this author Mirko Fillbrunn More articles by this author Hesen Li More articles by this author Adina Zhang More articles by this author Ashton Moradi More articles by this author Amy Guo More articles by this author Ashish M. Kamat More articles by this author Expand All Advertisement PDF downloadLoading ...