Aims: Given the changes to the treatment landscape for la/mUC in Australia and Taiwan, real-world data on therapies used in clinical practice remain limited. This cross-sectional study describes treatment patterns for la/mUC.
Methods: Data were abstracted from medical charts by physicians in Australia and Taiwan and captured by the LiveInsighter platform (online survey) from March-August 2025. Included patients were ≥18 years old with a confirmed Ia/mUC diagnosis before data collection and no clinical trial enrolment. Main objectives were to describe demographic/clinical characteristics and treatment patterns of patients receiving first-line/second-line systemic therapy. Analyses were descriptive without between-country comparisons.
Results: Data from 321 patients (Australia: n=161; Taiwan: n=160) were included by 88 physicians (Australia: n=48; Taiwan: n=40). In Australia and Taiwan, 67.7% and 63.1% of patients were male, mean age was 69.1 and 67.3 years, and 89.4% and 81.3% had an ECOG PS score of 0-1, respectively. At data collection, 23.6% (n=38) and 45.3% (n=73) of patients in Australia, and 30.6% (n=49) and 40.0% (n=64) in Taiwan, were receiving first-line treatment or completed first-line therapy with/without maintenance, respectively. The most frequent first-line treatments in Australia were platinum-based chemotherapy (PBC; 81.6%), nivolumab+gemcitabine+cisplatin (7.9%), and pembrolizumab monotherapy (5.3%); 2.6% received enfortumab vedotin+pembrolizumab (EV+P). In Taiwan, these were PBC (59.2%) and EV+P (14.3%); 4.1% received nivolumab+gemcitabine+cisplatin and 2.0% received EV monotherapy. At data collection, 31.1% (n=50) and 29.4% (n=47) of patients in Australia and Taiwan, respectively, were receiving second-line treatment; the most frequent were EV monotherapy (40.0%) and pembrolizumab (30.0%) in Australia, and nivolumab (34.0%), EV+P (19.1%), and EV monotherapy (19.1%) in Taiwan.
Conclusions: PBC was the most common first-line treatment at data collection in Australia and Taiwan. Despite regulatory approval, EV+P uptake remained limited. These findings highlight differences between guideline-recommended strategies and treatment utilization, suggesting addressing barriers to treatment access may optimize patient care.