Introduction & Objectives: Patients’ physical and social burden can be greatly affected following diagnosis and treatment of mUC. Published data on patient-reported symptom burden in the mUC setting are limited. This survey aimed to provide insight into patient-reported symptom burden at diagnosis and at time of data collection, treatment satisfaction, and unmet needs in patients with mUC in the Eu5. Materials & Methods: Using the Adelphi Metastatic Urothelial Cancer Disease Specific Programme, this cross-sectional study collected real-world data from December 2020 to April 2021 via patient chart extraction by physicians, physician surveys, and patient-reported outcome questionnaires. Patients receiving treatment for mUC in the Eu5 were invited to participate in a voluntary one-time questionnaire after their physician completed a survey and medical chart review, which collected diagnosis and treatment information. The patient questionnaire collected information on symptom burden and treatment satisfaction. Descriptive analysis was conducted. Results: 614 patients completed the questionnaire and had matched chart review data. At the time of data collection, 41% were receiving first-line (1L) treatment, 33% second line (2L), and 26% third line or later (3L+). Mean age at which patients first noticed symptoms was 66.8 years, and mean (SD) duration between symptom onset and consulting a doctor was 3.2 (4.12) months. At mUC diagnosis, the most common symptoms reported were pain (74%), hematuria (56%), and fatigue (50%). At data collection, 92% of patients reported having at least 1 symptom, and 29%, 33%, and 39% of patients receiving 1L, 2L, and 3L+ treatment, respectively, reported ≥4 symptoms. Fatigue, pain, and lack of energy were the most common symptoms reported in both the 1L and 2L. The top 5 patient-reported symptoms across treatments were similar and 3 of 5 were reported at the highest frequency in those receiving best supportive care (BSC) only in 2L (Figure 1). In Eu5, 47% and 48% of patients receiving 1L and 2L treatment, respectively, were completely satisfied with treatment. However, in the 3L+, 27% of patients were not satisfied; in the 1L and 2L, 37% and 31%, respectively, were satisfied but believed their treatment could work better (Figure 2). Conclusions: Patients with mUC reported a high symptom burden, with those currently receiving 2L or 3L+ treatment showing a higher burden than those receiving 1L treatment, and those receiving only BSC having a higher burden of fatigue/tiredness, pain and haematuria than those receiving anticancer treatment. Furthermore, >50% of patients were not satisfied with treatment or believed that it could work better. This highlights an unmet need in patients with mUC for newer therapies that can reduce symptom burden. Future studies should assess how newer therapies have affected patient symptom burden and investigate their level of patient satisfaction.

Patient-reported symptom burden and treatment satisfaction in patients with metastatic urothelial cancer (mUC) in France, Germany, Italy, Spain, and the UK (Eu5)