Impact of contemporary patterns of chemotherapy utilization on survival in patients with advanced cancer of the urinary tract: a Retrospective International Study of Invasive/Advanced Cancer of the Urothelium (RISC)

Bamias, Aristotelis; Tzannis, Kimon; Harshman, Lauren C.; Crabb, Simon J.; Wong, Yu Ning; Pal, Sumanta K.; Giorgi, Ugo De; Ladoire, Sylvain; Agarwal, Neeraj; Yu, Evan Y.; Niegisch, Günter; Necchi, Andrea; Sternberg, C.; Srinivas, Sandy; Alva, Ajjai; Vaishampayan, Ulka N.; Cerbone, Linda; Liontos, Michalis; Rosenberg, Jonathan E.; Powles, Thomas; Bellmunt, Joaquim; Galsky, Matthew D.

doi:10.1093/annonc/mdx692

Cited by 63 publications

(45 citation statements)

References 20 publications

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“…Of the 3,024 patients of the RISC database, 1,333 with advanced UTC, managed at 29 centers between 2000 and 2013, fulfilled selection criteria. Their baseline characteristics and detailed description of chemotherapy administered have been previously published . Cisplatin‐based first‐line chemotherapy was administered to 669 patients, carboplatin‐based to 399, and other therapies to 265.…”

Section: Resultsmentioning

confidence: 99%

“…The RISC database includes data of patients with localized muscle‐invasive or advanced UTC (defined as primary carcinoma of the urinary bladder, renal pelvis, ureter, or urethra). Data collection and quality control have been previously described . The study was approved by the ethics committees at each participating institution.…”

Section: Methodsmentioning

confidence: 99%

“…More importantly, a significant proportion of patients with aUTC do not receive cisplatin‐based chemotherapy mainly because of concerns of increased toxicity and/or limited efficacy in certain patient groups. In addition, 25% of patients do not receive cisplatin‐based chemotherapy in everyday practice despite eligibility according to recently established criteria .…”

Section: Introductionmentioning

confidence: 99%

“…The Retrospective International Study of Cancers of the Urothelium (RISC) database represents the largest multinational database of patients with urinary tract cancer worldwide . It includes patients regardless of their participation in clinical trials, treated in the U.S., Europe, Israel, and Canada during the last decade.…”

Section: Introductionmentioning

confidence: 99%

“…It thus ensures an adequately long follow‐up and wide representation of global contemporary trends in the use of chemotherapy for the treatment of aUTC, because it predates the approval of novel immunotherapies. Using this database, we recently showed the importance of applying eligibility‐for‐cisplatin criteria in order to select patients who derive maximum benefit from cisplatin‐based chemotherapy . We used this database to study long‐term survival among patients with aUTC treated with chemotherapy and to evaluate the importance of cisplatin use in this context.…”

Section: Introductionmentioning

confidence: 99%

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The Impact of Cisplatin- or Non-Cisplatin-Containing Chemotherapy on Long-Term and Conditional Survival of Patients with Advanced Urinary Tract Cancer

et al. 2019

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Background The impact of cisplatin use on long‐term survival of unselected patients with advanced urinary tract cancer (aUTC) has not been adequately investigated. We used a multinational database to study long‐term survival and the impact of treatment type in unselected patients with aUTC. Materials and Methods A total of 1,333 patients with aUTC (cT4bN0M0, cTanyN+M0, cTanyNanyM+), transitional‐cell, squamous, or adenocarcinoma histology who received systemic chemotherapy and had available survival data were selected. Long‐term survival was defined as alive at 3 years following initiation of first‐line chemotherapy. Conditional overall survival (COS) analysis was employed to study change in prognosis given time survived from initiation of first‐line chemotherapy. Results Median follow‐up was 31.7 months. The combination of cisplatin use and cisplatin eligibility accurately predicted long‐term survival. Eligible patients treated with cisplatin conferred a 31.6% probability of 3‐year survival (95% confidence interval [CI]: 25.1–38.3), and 2‐year COS for patients surviving 3 years after initiation of cisplatin‐based chemotherapy was 83% (95% CI: 59.7–93.5). The respective probabilities for patients who were ineligible for cisplatin or not treated with cisplatin despite eligibility were 14% (95% CI: 10.8–17.6) and 49.3% (95% CI: 28.2–67.4). Two‐year COS remained significantly different between these two groups up to 3 years after chemotherapy initiation. Conclusion Cisplatin‐based therapy was associated with the highest likelihood of long‐term survival in patients with aUTC and should be used in patients who fulfill the established eligibility criteria. Novel therapies are necessary to increase long‐term survival in cisplatin‐ineligible patients. Implications for Practice Long‐term, disease‐free survival is possible in one in four eligible‐for‐cisplatin patients with advanced urinary tract cancer (aUTC) treated with cisplatin‐based combination chemotherapy. Therefore, deviations from eligibility criteria should be avoided. Consolidation surgery should be considered in responders. These data provide benchmarks for the study of novel therapies in aUTC.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Impact of Cisplatin- or Non-Cisplatin-Containing Chemotherapy on Long-Term and Conditional Survival of Patients with Advanced Urinary Tract Cancer

et al. 2019

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The mutational pattern of homologous recombination repair genes in urothelial carcinoma and its correlation with immunotherapeutic response

Chen,

Tang,

Liu

et al. 2023

Cancer Medicine

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BackgroundThe mutational pattern of homologous recombination repair (HRR)‐associated gene alterations in Chinese urothelial carcinoma (UC) necessitates comprehensive sequencing efforts, and the clinical implications of HRR gene mutations in UC remain to be elucidated.Materials and MethodsWe delineated the mutational landscape of 343 Chinese UC patients from West China Hospital and 822 patients from The Cancer Genome Atlas (TCGA) using next‐generation sequencing (NGS). Data from 182 metastatic UC patients from MSK‐IMPACT cohort were used to assess the association between HRR mutations and immunotherapy efficacy. Comprehensive transcriptomic analysis was performed to explore the impact of HRR mutations on tumor immune microenvironment.ResultsAmong Chinese UC patients, 34% harbored HRR gene mutations, with BRCA2, ATM, BRCA1, CDK12, and RAD51C being the most prevalently mutated genes. Mutational signatures contributing to UC differed between patients with and without HRR mutations. Signature 22 for exposure to aristolochic acid was only observed in Chinese UC patients. The presence of HRR mutations was correlated with higher tumor mutational burden, neoantigen burden, and PD‐L1 expression. Importantly, patients with HRR mutations exhibited significantly improved prognosis following immunotherapy compared to those without HRR mutations.ConclusionsOur findings provide valuable insights into the genomic landscape of Chinese UC patients and underscore the molecular rationale for utilizing immunotherapy in UC patients with HRR mutations.

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Metastatic Carcinoma Urinary Bladder, Adjuvant Treatment and Follow-Up

Ganguly,

Chitikela,

Batra

2023

A Guide to Management of Urological Cancers

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Impact of contemporary patterns of chemotherapy utilization on survival in patients with advanced cancer of the urinary tract: a Retrospective International Study of Invasive/Advanced Cancer of the Urothelium (RISC)

Abstract: The importance of applying published criteria of eligibility-for-cisplatin was confirmed in a multinational, real-world setting in aUTC. The reasons for deviations from these criteria set targets to improve adherence. Effective therapies for cisplatin-ineligible patients are needed.

Cited by 63 publications

References 20 publications

The Impact of Cisplatin- or Non-Cisplatin-Containing Chemotherapy on Long-Term and Conditional Survival of Patients with Advanced Urinary Tract Cancer

The Impact of Cisplatin- or Non-Cisplatin-Containing Chemotherapy on Long-Term and Conditional Survival of Patients with Advanced Urinary Tract Cancer

The mutational pattern of homologous recombination repair genes in urothelial carcinoma and its correlation with immunotherapeutic response

Metastatic Carcinoma Urinary Bladder, Adjuvant Treatment and Follow-Up

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