Influence of best objective response to first‐line treatment on survival outcomes in advanced urothelial carcinoma in the era of sequential therapy with enfortumab vedotin
International Journal of Urology,
Год журнала:
2025,
Номер
unknown
Опубликована: Фев. 10, 2025
Objective
This
study
evaluated
whether
first‐line
treatment
affects
survival
outcomes
in
patients
with
advanced
urothelial
carcinoma
undergoing
sequential
therapy
chemotherapy,
immune
checkpoint
inhibitors,
and
enfortumab
vedotin.
Methods
multicenter
retrospective
included
57
treated
at
Hiroshima
University
Hospital
its
affiliated
institutions
between
2009
2024.
Patients
received
chemotherapy
as
a
(gemcitabine
plus
cisplatin
or
carboplatin),
followed
by
second‐line
inhibitors
(pembrolizumab
avelumab)
third‐line
Assessed
overall
time
to
failure.
Cox
regression
analysis
identified
prognostic
factors
for
survival.
Results
Over
median
follow‐up
of
20.5
months,
was
not
reached
after
treatment.
Gemcitabine
selected
31.6%
cases,
while
gemcitabine
carboplatin
chosen
68.4%
cases
the
treatment;
subsequently,
66.7%
pembrolizumab,
33.3%
avelumab
who
achieved
complete
partial
response
had
significantly
longer
survivals
from
both
vedotin
initiation
than
those
stable
progressive
disease.
In
that
responses,
more
frequently
therapy.
However,
treatment,
multivariate
only
disease
significant
predictor
worse
Conclusion
The
best
predicted
following
underscoring
value
carcinoma.
Язык: Английский
Hot Spots in Urogenital Basic Cancer Research and Clinics
Cancers,
Год журнала:
2025,
Номер
17(7), С. 1173 - 1173
Опубликована: Март 31, 2025
Urogenital
cancer
is
very
common
in
the
male
population
of
Western
countries,
a
problem
major
concern
for
public
health
systems,
and
frequent
test
subject
oncological
research.
In
this
narrative,
we
identify
main
hot
topics
clinics
basic
science
urological
last
few
years
(from
2021
onwards),
considering
information
given
abstracts
almost
300
original
articles
published
outstanding
journals
pathology,
urology,
science.
Once
defined,
top
ten
list
(the
2022
WHO
update
on
classification
urinary
genital
tumors,
new
entities
kidney
cancer,
cancer-omics,
Gleason
grading
system,
targeted
therapies
other
novel
renal
news
non-muscle
invasive
urothelial
carcinoma,
artificial
intelligence
urologic
intratumor
heterogeneity
influence
therapeutic
failures
neoplasms,
microbiome
its
tumor
aggressiveness,
ecological
principles
mathematics
applied
to
urogenital
study),
each
issue
independently
reviewed
an
attempt
put
together
most
relevant
updates
and/or
useful
features
accompanied
by
selected
illustrations.
This
review
article
addresses
some
interesting
current
spots
research
mainly
aimed
toward
clinicians,
including
pathologists,
urologists,
oncologists.
Readers
are
invited
explore
topic
further,
more
detailed
information,
addition
references
provided.
Язык: Английский
Efficacy and safety of BCG and immune checkpoint inhibitors in non‑muscle invasive bladder cancer: A meta‑analysis with exploratory chemotherapy comparisons
Oncology Letters,
Год журнала:
2025,
Номер
30(1), С. 1 - 17
Опубликована: Май 16, 2025
Bladder
cancer
(BC)
is
a
significant
global
health
concern
and
includes
non-muscle-invasive
BC
(NMIBC),
which
poses
challenges
due
to
recurrence
progression.
Immunotherapy,
such
as
immune
checkpoint
inhibitors
(ICIs)
Bacillus
Calmette-Guérin
(BCG),
shows
promise
particularly
in
cases
of
BCG
failure
or
BCG-unresponsive
NMIBC,
with
ICIs
emerging
potential
treatment
option
for
these
challenging
cases.
To
the
best
our
knowledge,
present
study
first
systematically
compare
efficacy
safety
NMIBC.
The
meta-analysis
identifies
response
predictors
outcomes,
can
help
recognizing
biomarkers
tumor
characteristics,
hemoglobin
levels
baseline
performance
status,
associated
therapy
response.
These
insights
may
guide
future
research
developing
personalized
strategies
non-responsive
NMIBC
Following
Preferred
Reporting
Standards
Systematic
Reviews
Meta-Analyses
guidelines,
systematic
literature
search
identified
relevant
studies
published
between
January
2015
April
2024.
Randomized
controlled
trials
clinical
involving
patients
BCG-refractory
were
included
primary
analysis.
Data
extraction
analysis
conducted
using
Review
Manager
version
5.4,
employing
random
effects
model.
risk
bias
assessment
followed
Cochrane
guidelines.
2,154
participants
across
10
evaluating
treatments
Primary
comparisons
focused
on
vs.
ICIs:
Pembrolizumab
significantly
improved
control
(OR,
4.67;
95%
CI,
1.43-15.25;
P=0.01),
progression-free
survival
(PFS;
OR,
4.85;
1.58-14.85;
P=0.006),
overall
(OS;
3.61;
1.28-10.19;
P=0.02).
Atezolizumab
similarly
outperformed
metastatic
disease
0.19;
0.06-0.59;
P=0.004)
lymph
node
involvement
0.43;
0.20-0.93;
P=0.03).
exhibited
favorable
profile
BCG,
fewer
incidents
anemia
2.87;
P=0.001)
diarrhea
1.79;
P=0.03),
despite
higher
rates
asthenia
7.33;
P<0.00001)
pyrexia
3.26;
P<0.00001).
Exploratory
chemotherapy
revealed
pembrolizumab's
advantages
terms
PFS
1.36;
P=0.02)
OS
1.31;
P=0.005),
while
atezolizumab
0.54;
P=0.0008).
Heterogeneity
was
low
(I2=0%)
but
high
(I2=81-95%).
In
conclusion,
ICIs,
pembrolizumab
atezolizumab,
demonstrate
superior
over
supporting
their
use
first-line
alternatives.
findings
advocate
paradigm
shift
managing
disease,
emphasizing
immunotherapy.
Язык: Английский
Evolving Treatment Landscape of Frontline Therapy for Metastatic Urothelial Carcinoma: Current Insights and Future Perspectives
Cancers,
Год журнала:
2024,
Номер
16(23), С. 4078 - 4078
Опубликована: Дек. 5, 2024
Cisplatin-based
chemotherapy
has
long
been
the
standard
first-line
(1L)
treatment
for
metastatic
urothelial
carcinoma
(mUC).
However,
up
to
50%
of
patients
with
mUC
may
be
ineligible
cisplatin
owing
comorbidities,
necessitating
alternative
primary
options.
Immune
checkpoint
inhibitors
(ICIs)
have
emerged
as
a
vital
those
unable
receive
cisplatin.
Nevertheless,
prognosis
advanced
UC
remains
dire
and
challenges
persist
in
optimizing
1L
therapy.
Recent
medical
advancements
redirected
attention
towards
innovative
drug
combinations
mUC.
The
combination
enfortumab
vedotin
(EV)
pembrolizumab
shown
significantly
improved
overall
progression-free
survival
rates
compared
alone.
This
can
used
who
are
cisplatin-ineligible
or
require
alternatives
chemotherapy.
While
platinum-based
continues
essential
many
patients,
approval
EV
treatments
signifies
major
breakthrough
cancer
care.
These
therapies
offer
enhanced
outcomes
terms
response
highlight
increasing
relevance
ICI-containing
regimens
frontline
review
provides
an
exhaustive
overview
current
landscape
explores
new
therapeutic
strategies,
aim
facilitating
clinical
decision-making
guiding
strategies
Язык: Английский