Study IDs Top Reason for Lack of Treatment in Patients With Bladder Cancer

More than a third of patients diagnosed with locally advanced, unresectable, or metastatic urothelial carcinoma in the preimmunotherapy era did not receive systemic anticancer treatment, with more than half of those patients sharing the same reason for not pursuing treatment, according to a recent study.

Lise Omland, a PhD candidate at the University of Copenhagen and Copenhagen University Hospital, and colleagues conducted the study and published its results in Acta Oncologica.

“The proportion of patients with locally advanced, unresectable, or metastatic urothelial carcinoma that do not receive systemic anticancer treatment and the reasons for lack of treatment are largely unknown,” the researchers wrote. “The aim of this study was to investigate the prevalence and overall survival of this patient group and reasons for omission of treatment.”

The retrospective, single-center cohort study assessed patients diagnosed with locally advanced, unresectable, or metastatic urothelial carcinoma between January 2010 and March 2016.

The researchers found that 100 patients—representing 34% of all patients diagnosed with locally advanced, unresectable, or metastatic urothelial carcinoma at the center during that period—did not receive systemic anticancer treatment.

More than half of the patients (59%) did not receive treatment due to poor physical condition, while 15% did not receive treatment due to decreased renal function, and 14% did not receive treatment due to patient preferences. The median overall survival in the group was 1.9 months (95% CI, 1.6-2.8 months).

“Prompt identification of advanced disease and interventions to optimize these patients for treatment are essential,” the investigators wrote. “Our findings underscore the compelling need for novel, better-tolerated treatment regimens in this frail patient group.”

Omland LH, Joensen UN, Toft BG, et al. Reasons for lack of treatment in patients with locally advanced, unresectable or metastatic urothelial carcinoma. Acta Oncol. 2022. doi:10.1080/0284186X.2022.2114378