A Head-to-Head Comparison of the First-Line Treatments for Locally Advanced or Metastatic Urothelial Cancer: Is There Still a Role for Chemotherapy? DOI Open Access
Lorenzo Gasperoni,

L. Del Bono,

Andrea Ossato

et al.

Cancers, Journal Year: 2024, Volume and Issue: 16(13), P. 2400 - 2400

Published: June 29, 2024

Background: Patients with locally advanced/metastatic urothelial cancer have been conventionally treated platinum-based chemotherapy. Recently, numerous new treatments proposed to improve overall survival (OS) and reduce adverse effects, but no direct head-to-head comparisons among these agents are available. Methods: The evaluated in our analyses included (a) monotherapy immune checkpoint inhibitors (ICI); (b) combinations of an ICI chemotherapy; (c) other drugs. Using OS as the endpoint, a series indirect were performed rank most effective regimens against both chemotherapy each other. Our analysis was based on application artificial intelligence software program (IPDfromKM method) that reconstructs individual patient data from information reported graphs Kaplan–Meier curves. Results: A total five studies published six articles included. In main analysis, nivolumab plus showed better compared (HR = 0.70, 95% CI: 0.59–0.82), while durvalumab tremelimumab benefit 0.95, CI 0.82–1.11). More interestingly, enfortumab vedotin pembrolizumab significantly prolonged alone 0.53, 0.45–0.63) 0.76, 0.60–0.97). Discussion conclusion: Among for advanced metastatic cancer, best efficacy terms OS. results support use this combination first-line treatment setting.

Language: Английский

Nectin-4-directed antibody-drug conjugates (ADCs): Spotlight on preclinical and clinical evidence DOI

Mohammad Javad Khosravanian,

Yousef Mirzaei,

Ali Hussein Mer

et al.

Life Sciences, Journal Year: 2024, Volume and Issue: 352, P. 122910 - 122910

Published: Sept. 1, 2024

Language: Английский

Citations

9
Enfortumab Vedotin With or Without Pembrolizumab in Metastatic Urothelial Carcinoma DOI Creative Commons

Shugo Yajima,

Kohei Hirose, Hitoshi Masuda

et al.

JAMA Network Open, Journal Year: 2025, Volume and Issue: 8(3), P. e250250 - e250250

Published: March 11, 2025

Importance Metastatic urothelial carcinoma (mUC) presents a therapeutic challenge with poor outcome. Enfortumab vedotin has emerged as promising treatment, necessitating comprehensive evaluation of its effectiveness and safety. Objective To synthesize the available evidence on enfortumab vedotin, both monotherapy in combination pembrolizumab, an mUC treatment for purpose guiding clinical decision-making future research. Data Sources Cochrane Library, MEDLINE (via PubMed), Google Scholar, Web Science were searched from database inception to August 31, 2024. Major conference abstracts 2019 2024 also included. Search strategy used Medical Subject Heading terms free-text keywords related vedotin. Study Selection Randomized trials prospective studies investigating adult patients Eleven met inclusion criteria. Extraction Synthesis Two independent reviewers extracted data assessed study quality using Risk Bias tool 2 Non-Randomized Studies Interventions tool. The meta-analysis random effects model, while network was performed frequentist approach. Main Outcomes Measures Primary outcomes disease control rate (DCR), objective response (ORR), 1-year survival rate. Results 11 included (3 randomized [27.3%] 8 nonrandomized [72.7%]) involved 2128 patients. Of these patients, 563 (26.5%) received plus 814 (38.3%) without 751 (35.3%) chemotherapy. pembrolizumab associated pooled DCR 86% (95% CI, 83%-89%), ORR 68% 64%-71%), 79% 75%-82%). had 73% 70%-76%), 43% 40%-47%), 52% 48%-56%). Network revealed that significantly outperformed chemotherapy (odds ratio [OR], 3.47; 95% 1.49-8.09; P = .004) (OR, 2.32; 1.75-3.06; < .001). Conclusions Relevance In this systematic review meta-analysis, showed high rates first-line settings, benefit later lines therapy. These findings underscore importance personalized approaches, research is warranted refine vedotin–based therapies management.

Language: Английский

Citations

1
Clinical Outcomes of Enfortumab Vedotin in Advanced Urothelial Carcinoma With Prior AvelumabVersusPembrolizumab Therapy DOI Creative Commons
Akinori Minato, Nobuki Furubayashi,

Toshihisa Tomoda

et al.

Anticancer Research, Journal Year: 2024, Volume and Issue: 44(8), P. 3419 - 3426

Published: July 26, 2024

Background/Aim: This study retrospectively evaluated whether enfortumab vedotin (EV) monotherapy is effective as a late-line treatment according to prior type in patients with advanced urothelial carcinoma (UC). Patients and Methods: We assessed consecutive from the Uro-Oncology Group Kyushu population lower upper urinary tract cancer treated EV after platinum-based chemotherapy immune checkpoint inhibitor therapy failure between December 2021 March 2024. In particular, receiving avelumab maintenance or pembrolizumab before for UC were analyzed compared response rate, progression-free survival (PFS), overall (OS). Results: Of 80 enrolled patients, 31 49 received therapy, respectively. The groups had comparable objective rates (48.4% vs. 44.9%, p=0.820) disease control (77.4% 67.3%, p=0.448). These two showed no significant difference PFS initiation of (median: 6.4 months 4.2 months, p=0.184); meanwhile, group better OS than 16.0 10.2 p=0.019). Moreover, median first-line was longer (40.3 24.7 p=0.054). On multivariate analysis, reduced mortality risk by 47% (95% confidence interval=0.27-1.03; p=0.059). Conclusion: provides favorable outcomes UC.

Language: Английский

Citations

6
New capabilities of 2nd and subsequent therapy lines in metastatic urothelial cancer DOI Open Access
А. S. Kalpinskiy, O. A. Mailyan

Cancer Urology, Journal Year: 2025, Volume and Issue: 20(4), P. 75 - 89

Published: Feb. 27, 2025

According to the World Health Organization data, in 2022 bladder cancer (BC) was 9 th (614,298) most common cancer. In Russia, patients (58.8 %) were diagnosed with non-muscle invasive BC (stage I) but percentage of muscle (stages II–III) and metastatic (mBC) remains high: 32.1 8.3 % cases, respectively. Mortality first year since diagnosis 12.28 %. Decrease mortality last 10 years Russia by 22.84 is probably due development new more effective drugs for mBC treatment which are subject this literature review. Currently, 2 nd line standards changed appearance guidelines majority world oncological societies classified as conjugated targeted drugs. progression during platinum-based chemotherapy and/or immune checkpoint inhibitors, therapy conjugate enfortumab vedotin (EV) possible. Enfortumab its class drug, a monoclonal antibody against nectin-4 protein highly expressed urothelial carcinoma cytotoxic drug monomethyl auristatin E (ММАЕ) affecting microtubules. EV approved US Food Drug Administration (FDA) December 2019 based on phase II trial EV-201 part expedited review program high rate objective responses inoperable locally advanced who previously received inhibitors. 2023. Median overall survival all I–III trials around 1 varied between 11.7 12.91 months, progression-free little below 6 months 5.5 5.8 months. UNITE routine practice median start higher than randomized trails: 6.8 14.4 Objective response clinical above 40 %; particular, I EV-101 it 43 %, – 44 III EV-301 41 52 while complete rates 5; 12; 6.9 7 EV-301, decreased risk death 30 compared standard (ST) significantly increased from 8.94 ST group group. The 37 group, 3.71 ( p <0.00001). Additionally, 2-fold ST: 41.32 versus 18.58 Approximately alive at study 20 Safety profile also demonstrates similar results intermediate primary analyses. treatment-associated adverse events grade or both analyses (51.4 52.4 respectively) (49.8 50.5 respectively). rash, hyperglycemia, peripheral neuropathy. At same time, quality life confirms safety effectiveness carcinoma.

Language: Английский

Citations

0
Perioperative cisplatin-based chemotherapy for muscle-invasive bladder cancer: a decision analysis DOI
Luca Afferi, Beate Jahn, Amar H. Kelkar

et al.

World Journal of Urology, Journal Year: 2025, Volume and Issue: 43(1)

Published: March 30, 2025

Language: Английский

Citations

0
A Head-to-Head Comparison of the First-Line Treatments for Locally Advanced or Metastatic Urothelial Cancer: Has Chemotherapy Still a Role? DOI Open Access
Lorenzo Gasperoni,

L. Del Bono,

Andrea Ossato

et al.

Published: June 10, 2024

Background: Patients with locally advanced/metastatic urothelial cancer have been conventionally treated platinum-based chemotherapy. Recently, numerous new treatments proposed to improve overall survival (OS) and reduce adverse effects, but no head-to-head direct comparison is available. Methods: We considered: a) monotherapy immune checkpoint inhibitors (ICI); b) combinations of an ICI chemotherapy; c) other drugs. An indirect was performed identify the regimens most effective in prolonging OS compared each Results: A total 6 articles were included. In our final analysis, nivolumab plus chemotherapy showed better (HR= 0.70, 95%CI: .59-0.82); while durvalumab tremelimumab benefit (HR=0.95, 95%CI 0.82-1.11). More interestingly, enfortumab vedotin pembrolizumab significantly prolonged both alone (HR=0.53, 0.45-0.63) 0.76, 0.60-0.97). Discussion conclusion: Among for advanced metastatic cancer, + best efficacy terms OS. Our results support use this combination as first-line treatment setting.

Language: Английский

Citations

1
HRQoL in patients receiving EV versus chemotherapy DOI

Maria Chiara Masone

Nature Reviews Urology, Journal Year: 2024, Volume and Issue: 21(5), P. 257 - 257

Published: April 16, 2024

Language: Английский

Citations

0
Editorial Comment on “Real‐world treatment patterns and quality of life among patients with locally advanced or metastatic urothelial carcinoma living in Saudi Arabia, South Korea, Taiwan, and Turkey” DOI
Giulia Claire Giudice,

Guru P. Sonpavde

International Journal of Urology, Journal Year: 2024, Volume and Issue: 31(8), P. 943 - 944

Published: June 2, 2024

Giulia Claire Giudice, MD: No conflicts of interest to declare.

Language: Английский

Citations

0
A Head-to-Head Comparison of the First-Line Treatments for Locally Advanced or Metastatic Urothelial Cancer: Is There Still a Role for Chemotherapy? DOI Open Access
Lorenzo Gasperoni,

L. Del Bono,

Andrea Ossato

et al.

Cancers, Journal Year: 2024, Volume and Issue: 16(13), P. 2400 - 2400

Published: June 29, 2024

Background: Patients with locally advanced/metastatic urothelial cancer have been conventionally treated platinum-based chemotherapy. Recently, numerous new treatments proposed to improve overall survival (OS) and reduce adverse effects, but no direct head-to-head comparisons among these agents are available. Methods: The evaluated in our analyses included (a) monotherapy immune checkpoint inhibitors (ICI); (b) combinations of an ICI chemotherapy; (c) other drugs. Using OS as the endpoint, a series indirect were performed rank most effective regimens against both chemotherapy each other. Our analysis was based on application artificial intelligence software program (IPDfromKM method) that reconstructs individual patient data from information reported graphs Kaplan–Meier curves. Results: A total five studies published six articles included. In main analysis, nivolumab plus showed better compared (HR = 0.70, 95% CI: 0.59–0.82), while durvalumab tremelimumab benefit 0.95, CI 0.82–1.11). More interestingly, enfortumab vedotin pembrolizumab significantly prolonged alone 0.53, 0.45–0.63) 0.76, 0.60–0.97). Discussion conclusion: Among for advanced metastatic cancer, best efficacy terms OS. results support use this combination first-line treatment setting.

Language: Английский

Citations

0