HUMANISTIC BURDEN ASSOCIATED WITH INTRAVESICAL TREATMENT OF PATIENTS WITH NON-MUSCLE INVASIVE BLADDER CANCER IN THE UNITED STATES.

Bladder cancer (BC) is the sixth most common cancer in the US and ∼75% of incident cases are non-muscle invasive BC (NMIBC). Current treatments differ by risk evaluation following the first transurethral resection of the bladder tumor. These include cystectomy and bladder preservation therapies (e.g., intravesical bacillus Calmette-Guérin [BCG]). While the burden of cystectomy is significant1, the burden of intravesical treatments is less well understood. This study aimed to describe the life impacts of intravesical therapies for NMIBC from the perspective of the patient. A cross-sectional online survey design was used. Study participants recruited from US patient communities were eligible if they: (1) had a self-reported diagnosis of NMIBC, (2) had intravesical treatment for NMIBC (i.e., BCG, gemcitabine, mitomycin, docetaxel, paclitaxel, epirubicin, doxorubicin) within the past year, and (3) were aged ≥18 years. Individuals were excluded if they were participating in a clinical trial, had other cancers (including muscle invasive or metastatic BC), or had been treated with erdafitinib. Prior to data collection, survey questions were evaluated for comprehension and salience to the NMIBC patient experience in one-on-one interviews. Participants' treatment experiences were evaluated using custom statements with 11-point numerical rating scales. Additionally, validated patient-reported outcome measures were used under license to capture work productivity (Work Productivity and Activity Impairment-Special Health Problem) and impacts of disease-specific symptoms (NCCN/FACT Bladder Symptom Index [FBlSI-18]). The study was approved by the WIRB-Copernicus Group Independent Review Board. Overall, 171 respondents completed the survey (average time=20 minutes; completion rate=36%). The majority were male (64%), ≥55 years old (70%), and attended college (87%). Participants frequently reported receiving BCG (83%), gemcitabine (27%), gemcitabine+docetaxel (13%), mitomycin c(12%), and docetaxel (12%) intravesically during the past year. Participants reported high levels of agreement to having intention to complete their full treatment course and willingness to try a different therapy if needed. Figure 1 shows additional details. Among participants employed for pay (n=77), notable work time missed (absenteeism=17%), impairment while at work (presenteeism=51%), overall work productivity loss (59%), and impairment in daily activities (40%) was reported for the past 7 days due to NMIBC.The FBlSI-18 scale found BC symptoms burden related to impacts on emotional (e.g., worry about their condition worsening) and functional well-being (e.g., low contentment with their HRQoL), physical symptoms (e.g., poor sleep), and bothersome treatment side effects. This study filled an important gap by describing the real-world intravesical treatment experience and its impact on the HRQoL of patients with NMIBC. Participants generally felt adequately informed about treatment, felt expectation of the treatment matched actual experience, and intended to complete their full treatment course. Participants reported high work impairment due to having NMIBC and disease symptom burden negatively impacting their well-being despite receiving intravesical treatment. Overall, these results point to an unmet need in the treatment of NMIBC and participants' willingness to try a different treatment if recommended. [ABSTRACT FROM AUTHOR]