PMID- 37846191
OWN - NLM
STAT- MEDLINE
DCOM- 20240306
LR  - 20240306
IS  - 1549-490X (Electronic)
IS  - 1083-7159 (Print)
IS  - 1083-7159 (Linking)
VI  - 29
IP  - 3
DP  - 2024 Mar 4
TI  - Evaluating Oncologists' Practice Patterns and Decision-Making in Locally Advanced 
      or Metastatic Urothelial Carcinoma: The US Physician PARADIGM Study.
PG  - 244-253
LID - 10.1093/oncolo/oyad267 [doi]
AB  - BACKGROUND: The treatment landscape for locally advanced/metastatic urothelial 
      carcinoma (la/mUC) has evolved. This study examined US prescribing patterns and 
      clinical decision-making for first-line (1L) and first-line maintenance (1LM) 
      treatment. MATERIALS AND METHODS: US-based oncologists (N = 150) completed an 
      online survey on patient demographics, practice patterns, and important factors 
      considered in 1L/1LM selection. Multivariable logistic regression was used to 
      assess factors associated with more vs less frequent 1L/1LM prescribing. RESULTS: 
      Physician reports estimated that 23% of patients with la/mUC had not received any 
      systemic therapy in the previous 6 months; however, 46% received 1L, 32% received 
      second-line, and 22% received subsequent-line systemic treatments. Of patients 
      who were receiving 1L treatment, 72% were estimated to be receiving 1L 
      platinum-based chemotherapy. Around 69% of patients eligible for 1LM received the 
      treatment. Physicians categorized as frequent prescribers reported overall 
      survival (OS), disease control rate (DCR), and rate of grade 3/4 adverse events 
      (AEs) as factors associated with 1L treatment selection (all P < .05). OS, rate 
      of grade 3/4 immune-mediated AEs, and inclusion in institutional guidelines were 
      reported as attributes used in 1LM treatment selection (all P < .05). 
      Multivariable analysis revealed OS, DCR, and rate of grade 3/4 AEs as important 
      factors in oncologists' 1L treatment selection; academic practice setting and use 
      of Response Evaluation Criteria in Solid Tumors version 1.1 were associated with 
      1LM use (all P < .05). CONCLUSION: OS and AEs were found to be relevant factors 
      associated with offering 1L and 1LM treatment. Variability exists in physicians' 
      decision-making in the real-world setting for la/mUC.
CI  - (c) The Author(s) 2023. Published by Oxford University Press.
FAU - Gupta, Shilpa
AU  - Gupta S
AD  - Department of Hematology and Medical Oncology, Taussig Cancer Institute, 
      Cleveland Clinic Foundation, Cleveland, OH, USA.
FAU - Costantino, Halley
AU  - Costantino H
AD  - Cerner Enviza, an Oracle company, Kansas City, MO, USA.
FAU - Ike, Chiemeka
AU  - Ike C
AD  - EMD Serono, Inc., Rockland, MA, USA, an affiliate of Merck KGaA.
FAU - Gupta, Shaloo
AU  - Gupta S
AD  - Cerner Enviza, an Oracle company, Kansas City, MO, USA.
FAU - Bhanegaonkar, Abhijeet
AU  - Bhanegaonkar A
AD  - EMD Serono, Inc., Rockland, MA, USA, an affiliate of Merck KGaA.
FAU - Su, Cathy
AU  - Su C
AD  - Cerner Enviza, an Oracle company, Kansas City, MO, USA.
FAU - Thakkar, Sheena
AU  - Thakkar S
AD  - Pfizer, New York, NY, USA.
FAU - Mackie, deMauri S
AU  - Mackie DS
AD  - Cerner Enviza, an Oracle company, Kansas City, MO, USA.
FAU - Devgan, Geeta
AU  - Devgan G
AD  - Pfizer, New York, NY, USA.
FAU - Katzenstein, Howard M
AU  - Katzenstein HM
AD  - EMD Serono, Inc., Rockland, MA, USA, an affiliate of Merck KGaA.
FAU - Liu, Frank X
AU  - Liu FX
AD  - EMD Serono, Inc., Rockland, MA, USA, an affiliate of Merck KGaA.
LA  - eng
GR  - 10.13039/100004755/EMD Serono, Inc., Rockland, MA, USA/
PT  - Journal Article
PL  - England
TA  - Oncologist
JT  - The oncologist
JID - 9607837
SB  - IM
MH  - Humans
MH  - *Carcinoma, Transitional Cell/drug therapy
MH  - *Urinary Bladder Neoplasms/pathology
MH  - Response Evaluation Criteria in Solid Tumors
MH  - *Oncologists
MH  - *Physicians
PMC - PMC10911905
OTO - NOTNLM
OT  - chemotherapy
OT  - decision-making
OT  - immune checkpoint inhibitor
OT  - systemic therapy
OT  - urinary bladder cancer
COIS- Shilpa Gupta is a consultant for EMD Serono, Inc., Rockland, MA, USA, an 
      affiliate of Merck KGaA. Halley Costantino, Shaloo Gupta, Cathy Su, and deMauri 
      S. Mackie are employees of Cerner Enviza. Cerner Enviza was paid by EMD Serono, 
      Inc., Rockland, MA, USA, an affiliate of Merck KGaA, to conduct this study. 
      Chiemeka Ike and Abhijeet Bhanegaonkar are employees of EMD Serono, Inc., 
      Rockland, MA, USA, an affiliate of Merck KGaA. Howard Katzenstein and Frank X. 
      Liu were employees of EMD Serono, Inc., Rockland, MA, USA, an affiliate of Merck 
      KGaA at the time of the study. Sheena Thakkar and Geeta Devgan are employees of 
      Pfizer Inc.
EDAT- 2023/10/17 06:42
MHDA- 2024/03/06 06:43
PMCR- 2023/10/16
CRDT- 2023/10/17 03:48
PHST- 2023/04/28 00:00 [received]
PHST- 2023/08/29 00:00 [accepted]
PHST- 2024/03/06 06:43 [medline]
PHST- 2023/10/17 06:42 [pubmed]
PHST- 2023/10/17 03:48 [entrez]
PHST- 2023/10/16 00:00 [pmc-release]
AID - 7319374 [pii]
AID - oyad267 [pii]
AID - 10.1093/oncolo/oyad267 [doi]
PST - ppublish
SO  - Oncologist. 2024 Mar 4;29(3):244-253. doi: 10.1093/oncolo/oyad267.