Comorbidity burden and risk factors (RFs) for peripheral neuropathy (PN) and their prevalence in patients (pts) with locally advanced or metastatic urothelial carcinoma (la/mUC): Combined results of 2 systematic literature reviews (SLRs) and a meta-analysis.

Abstract

e23313 Background: Despite advances in the treatment options for la/mUC, concerns remain about the occurrence of adverse events, such as PN, in daily practice. This study aimed to identify RFs associated with the development of PN and to analyze the prevalence of these RFs in pts with la/mUC to identify those most at risk. Methods: We conducted an SLR of real-world evidence (RWE) in full-text publications from 2014-2024 to identify RFs for PN in any population in studies reporting univariate (UVA) and/or multivariate analyses (MVA). The relevance of RFs was determined based on a composite analysis whereby > 50% UVA and MVA were considered statistically significant for PN. A second SLR was conducted to identify the prevalence of the identified RFs in pts with la/mUC receiving first-line (1L) treatment. Baseline characteristics of these studies were meta-analyzed to determine the pooled prevalence of relevant RFs for PN. Results: In 250 RWE studies assessing RFs for PN, 14 categories of RFs were identified, of which 9 were considered relevant. Based on MVA, categories significantly associated with PN were: performance status (100% of analyses), anemia (100%), diabetes (duration, 81%; glycosylated hemoglobin A1C, 73%), older age (71%), hypertension (57%), cardiovascular disease (59%), abnormal estimated glomerular filtration rate (eGFR; categorical variable, 100%), abnormal body mass index (BMI; categorical variable, 62%), and comorbidity score (64%) . Five categories (sex, smoking, alcohol, dyslipidemia, and liver function) had either heterogeneous results or were nonsignificant. The second SLR identified 109 RWE studies of 1L treatment in la/mUC. Results of the meta-analyses of RF prevalence are presented in the Table. Conclusions: Coexisting comorbidities in la/mUC increase the risk of developing PN, a disabling and difficult-to-treat condition. The prevalence of identified RFs relevant for PN ranged from 15% to 66% in the la/mUC population. The burden of PN may be successfully reduced by choosing optimal therapies and instituting appropriate clinical management for pts in whom these RFs are present. RF category Pooled prevalence in 1L la/mUC treatment, % (95% CI) ECOG PS ≥2 (n=48) 17.11 (14.57-19.99) Anemia (n=17) 29.55 (20.01-41.30) eGFR <60 mL/min/1.73m 2 (n=12) 51.84 (43.36-60.22) Diabetes (n=15) 15.38 (11.55-20.19) Age ≥65 years (n=9) 66.10 (56.72-74.37)(Mean age, 69.02 years [n=51]) Charlson Comorbidity Index >2 (n=20) 29.78 (16.77-47.16) Abnormal BMI (<18.5 [n=2] or ≥30 kg/m 2 [n=6]) <18.5 kg/m 2 : 4.12 (2.00-8.30) ≥30 kg/m 2 : 16.50 (12.47-21.53) Cardiovascular disease (n=4) 44.19 (24.42-65.99) Hypertension (n=10) 37.78 (28.18-48.44)