# Trend in overall survival from the start of first-line chemotherapy in patients with metastatic urothelial carcinoma

## TL;DR

The study finds that newer treatments for advanced bladder cancer improve patient survival over time.

## Contribution

The study identifies a survival trend linked to newer therapies in metastatic urothelial carcinoma.

## Key findings

- Newer agents like pembrolizumab and enfortumab vedotin prolonged overall survival from first-line therapy.
- Sequential treatment with these agents in real-world practice is associated with improved survival.
- Overall survival has increased over time since the initiation of first-line therapy.

## Abstract

New approaches involving immune checkpoint inhibitors and antibody-drug conjugates prolong overall survival in patients with metastatic urothelial carcinoma. However, the access to such systemic therapy in clinical practice is suboptimal, and whether these agents improve overall survival in patients with metastatic urothelial carcinoma over time remains unclear. Hence, we investigated the overall survival trend from the initiation of first-line therapy with these agents to identify changes due to the medication and time of treatment initiation. We retrospectively evaluated 195 patients from a single center. They were treated with chemotherapy, pembrolizumab, or avelumab or enfortumab vedotin. The treatment was categorized into chemotherapy, pembrolizumab or avelumab/enfortumab vedotin period. The new agents prolonged overall survival from the start of first-line therapy. Furthermore, sequential treatment with these agents in real-world clinical practice has been reported to prolong overall survival. These study results will have major implications when a new first-line therapy is approved in the future.

The prevalence of sequential treatment in the real-world practice of metastatic urothelial carcinoma was investigated. Overall survival was found to have increased over time from the initiation of first-line therapy.