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outcomes among patients with metastatic urothelial cancer (mUC) in the real-world setting.Methods: This was a retrospective analysis of Truven Health MarketScanÒ Commercial, Medicare Supplemental, and Coordination of Benefits (Medicare) databases. Patients with a primary diagnosis of mUC, 18 years old, received ICI for any line of treatment between 1/1/2016 -6/30/2019, and continuously enrolled in the database from 6 months prior to 1 month following the metastatic date were analyzed. AD was identified at any time prior to ICI therapy initiation. Time to treatment discontinuation was used as a proxy to quantify ICI treatment outcomes.Results: Of the 455 eligible patients, 71 (16%) had a prior AD. Among those with AD, the most common was type 1 diabetes (25%), followed by rheumatoid arthritis (10%) and pernicious anemia (10%), while 28% had a history of two or more ADs. Patients with vs. without prior AD were older (mean age 70.4 vs. 66.5; p<0.001) and had a higher co-morbidity burden. There was a shorter median unadjusted time to ICI treatment discontinuation among patients with a prior AD (6.82 months; 95% CI¼3.93-29.02) vs. without (8.13 months; 95% CI¼6.49-12.50), but findings were not statistically significant (p¼0.27). Adjusting for age, sex, comorbidity, and line of therapy, there was no significant difference in time to ICI treatment discontinuation between patients with vs. without prior AD (HR¼1.29; 95%CI¼0.87-1.90).Conclusions: There was a shorter time to treatment discontinuation in patients with vs. without prior AD, but findings were not statistically significant. Broader inclusion of patients with mUC reflective of real-world populations in ICI clinical studies will better define tolerance and efficacy of novel therapies for urothelial cancer.Legal entity responsible for the study: Genentech.

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