A narrative review of peripheral blood parameters for urothelial carcinoma treated with systemic antitumor drugs

Nagai, Takashi; Naiki, Taku; Sugiyama, Yosuke; Etani, Toshiki; Aoki, Maria; Gonda, Masakazu; Morikawa, Toshiharu; Iida, Kei; Tomiyama, Nami; Ando, Ryosuke; Kawai, Noriyasu; Yasui, Takahiro

doi:10.21037/tau-22-805

Cited by 3 publications

(1 citation statement)

References 82 publications

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“…The biomarkers ICIs and EV have been determined in many investigations for the prognosis of patients with la/mUC treated with platinum-based chemotherapy [9]. One such marker is the immune-nutritional status, which is related to a patient's prognosis and health during treatment.…”

Section: Introductionmentioning

confidence: 99%

C-Reactive Protein Is a Potential Prognostic Marker in Patient with Advanced or Metastatic Urothelial Carcinoma Treated with Enfortumab Vedotin: A Multi-Center Retrospective Study

Morikawa,

Naiki,

Sugiyama

et al. 2024

Cancers

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Background: In the EV-301 trial, enfortumab vedotin prolonged survival in patients with locally advanced or metastatic urothelial carcinoma previously treated with platinum-based therapy and programmed cell death 1/programmed death-ligand 1 inhibitor. However, real-world Asian data are limited, and potential prognostic markers are non-existent. We aimed to investigate potential prognostic markers for enfortumab vedotin therapy in Asian patients. Methods: We retrospectively enrolled 61 Japanese patients treated with enfortumab vedotin therapy at our hospital and affiliated hospitals between January 2019 and September 2023. Results: Enrolled patients (38 men, 23 women; median age 74 [IQR: 68–79] years) had bladder cancer (26 patients) or upper-tract urothelial carcinoma (35 patients). Fifty-four patients reported adverse events (grade >3 in 12). Skin disorders, pruritus, and neuropathy were common adverse effects. The median overall survival was 17.1 months (95% confidence interval: 10.0–not applicable). In multivariate analysis, the C-reactive protein level was an independent marker predicting favorable overall survival with enfortumab vedotin. Patient characteristics did not differ between C-reactive protein-high and -low groups. Conclusions: Our study provides real-world data showing that enfortumab vedotin prolonged survival in Asian patients similar to the EV-301 trial. Additionally, the C-reactive protein level might be considered a prognostic marker of enfortumab vedotin therapy in such patients.

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Section: Introductionmentioning

confidence: 99%

C-Reactive Protein Is a Potential Prognostic Marker in Patient with Advanced or Metastatic Urothelial Carcinoma Treated with Enfortumab Vedotin: A Multi-Center Retrospective Study

Morikawa,

Naiki,

Sugiyama

et al. 2024

Cancers

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Experience and Prognostic Analysis with Avelumab Switch Maintenance Treatment in Metastatic Urothelial Carcinoma

Isobe,

Naiki,

Sugiyama

et al. 2024

Oncology

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Introduction: Avelumab is approved for metastatic urothelial carcinoma (mUC) maintenance therapy and prolongs overall survival (OS). We explored trends related to avelumab treatment of mUC patients. Methods: A total of 72 patients with mUC treated with first-line chemotherapy, from January 2019 to November 2022, at our affiliated institutions, were analyzed. We compared clinical parameters and the prognosis of patients treated with avelumab (Ave; n=43), because of progression during first-line chemotherapy, with untreated patients (Ave-untreated; n=29). Among the Ave-treated group, we classified patients showing a complete or partial response or stable disease in their best response to avelumab maintenance therapy as avelumab (Ave)-suitable patients; these were retrospectively analyzed. Potential prognostic factors, including the geriatric nutritional risk index (GNRI) for determining patients suitable for Ave, were evaluated. Results: The basic clinical parameters of patients when first-line treatment was initiated were not statistically different between the two groups. The Ave-suitable group (median 26.6 months, 95% confidence interval [CI]: 19.4–not reached [NR]) showed significantly longer median OS after first-line treatment than the Ave-untreated group (median 12.0 months, 95% CI: 7.5–NR) with tolerable adverse events. The cut-off values of prognostic factors were set by receiver operating characteristic curve. Low age and GNRI sustainability revealed as significant prognostic factors for being Ave-suitable both in univariate and multivariate analysis. Conclusion: In mUC, avelumab maintenance prolonged OS within tolerable safety profiles. GNRI sustainability may be used as biomarker to predict being Ave-suitable.

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The prognostic efficacy of a sustainable geriatric nutritional risk index for avelumab switch maintenance therapy in metastatic urothelial carcinoma

Isobe,

Naiki,

Sugiyama

et al. 2023

Preprint

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Background Metastatic urothelial carcinoma (mUC) has a poor prognosis. Avelumab is approved for mUC maintenance therapy and prolongs overall survival. However, real-world data, including the prognostic analysis of maintenance therapy, is limited. In this study, we explore trends related to avelumab treatment of mUC patients. Methods A total of 72 mUC patients treated with first-line chemotherapy, from January 2019 to November 2022, at Nagoya City University Hospital or its seven affiliated institutions, were analyzed. We retrospectively compared clinical parameters and the prognosis of avelumab (Ave)-suitable and treated patients (n = 43) and those untreated (Ave-unsuitable; n = 29) because of progression during first-line chemotherapy. Kaplan–Meier curves displayed survival and recurrence rates. Potential prognostic factors, including the geriatric nutritional risk index (GNRI) for determining patients suitable for Ave, were evaluated using univariate and multivariate Cox regression analyses. Results Basic clinical parameters of patients when first-line treatment was initiated were not statistically different between the two groups. The Ave-suitable group (median 26.6 months, 95% confidence interval [CI]: 18.8–not reached [NR]) showed significantly longer median overall survival (OS) after first-line treatment than the Ave-unsuitable group (median 12.0 months, 95% CI: 7.5–NR) with tolerable adverse events. The cut-off values of prognostic factors were set by receiver operating characteristic curve. Multivariate analysis revealed GNRI sustainability as the only significant prognostic factor for being Ave-suitable (95% CI: 1.14–20.6, hazard ratio: 4.83). Conclusion Avelumab switch maintenance therapy for mUC prolonged OS and showed tolerable safety profiles. GNRI sustainability may be an excellent biomarker for predicting being Ave-suitable.

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A narrative review of peripheral blood parameters for urothelial carcinoma treated with systemic antitumor drugs

Cited by 3 publications

References 82 publications

C-Reactive Protein Is a Potential Prognostic Marker in Patient with Advanced or Metastatic Urothelial Carcinoma Treated with Enfortumab Vedotin: A Multi-Center Retrospective Study

C-Reactive Protein Is a Potential Prognostic Marker in Patient with Advanced or Metastatic Urothelial Carcinoma Treated with Enfortumab Vedotin: A Multi-Center Retrospective Study

Experience and Prognostic Analysis with Avelumab Switch Maintenance Treatment in Metastatic Urothelial Carcinoma

The prognostic efficacy of a sustainable geriatric nutritional risk index for avelumab switch maintenance therapy in metastatic urothelial carcinoma

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