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Open Access 01-12-2023 | Research

The prognostic significance of histologic variant on survival outcomes in patients with metastatic urothelial carcinoma receiving immune checkpoint inhibitor therapy

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

Published in: BMC Cancer | Issue 1/2023

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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Title: The prognostic significance of histologic variant on survival outcomes in patients with metastatic urothelial carcinoma receiving immune checkpoint inhibitor therapy
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
Publication date: 01-12-2023
Publisher: BioMed Central
Published in: BMC Cancer / Issue 1/2023
Electronic ISSN: 1471-2407
DOI: https://doi.org/10.1186/s12885-023-11398-w

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