The Prognostic Significance of Histologic Variant on Survival Outcomes in Patients with Metastatic Urothelial Carcinoma Receiving Immune Checkpoint Inhibitor Therapy

Overview

Journal BMC Cancer

Publisher Biomed Central

Specialty Oncology

Date 2023 Sep 15

PMID 37715113

Authors

Tsung-Han Tsai

Po-Jung Su

Shih-Yu Huang

Ming-Chun Kuo

Chang-Ting Lin

Chia-Che Wu

Hao-Lun Luo

Chien-Hsu Chen

Chih-Chi Chou

Ting-Ting Liu

Chun-Chieh Huang

Kai-Lung Tsai

Yu-Li Su

Affiliations

Soon will be listed here.

Abstract

Background: While the treatment guidelines have been established for pure urothelial carcinoma (pUC), patients with variant type urothelial carcinoma (vUC) face limited effective treatment options. The effectiveness of immune checkpoint inhibitors (ICI) in patients with vUC remains uncertain and necessitates additional research.

Method: We conducted a retrospective, multicenter study to explore the effectiveness of ICI in patients with pUC or vUC in Taiwan. We evaluated the overall response rate (ORR) through univariate logistic regression analysis and examined the overall survival (OS) and progression-free survival (PFS) using Kaplan-Meier analysis. Additionally, we employed univariate and multivariate Cox proportional hazards models to analyze the data.

Result: A total of 142 patients (116 pUC, 26 vUC) were included in our final analysis. The ORR was marginally higher in patients with pUC compared to those with vUC (34.5% vs. 23.1%, p = 0.26). Among all patients, 12.9% with pUC achieved a complete response (CR) after ICI treatment, while no vUC cases achieved CR (p = 0.05). There were no significant differences in PFS (median 3.6 months vs. 4.1 months, p = 0.34) or OS (median 16.3 months vs. 11.0 months, p = 0.24) when comparing patients with pUC or vUC. In the subgroup analysis, patients with pUC who underwent first-line ICI treatment exhibited significantly improved OS compared to those with vUC (24.6 months vs. 9.1 months, p = 0.004).

Conclusion: The use of ICI as monotherapy is a feasible and effective treatment approach for patients with metastatic vUC.

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