Prognostic Impact of Histologic Subtype and Divergent Differentiation in Patients with Metastatic Urothelial Carcinoma Treated with Enfortumab Vedotin: A Multicenter Retrospective Study

Minato, Akinori; Furubayashi, Nobuki; Nagata, Yujiro; Tomoda, Toshihisa; Masaoka, Hiroyuki; Song, Yoohyun; Hori, Yoshifumi; Kiyoshima, Keijiro; Negishi, Takahito; Kuroiwa, Kentaro; Seki, Narihito; Tomisaki, Ikko; Harada, Kenichi; Nakamura, Motonobu; Fujimoto, Naohiro

doi:10.3390/curroncol31020064

Cited by 6 publications

(1 citation statement)

References 29 publications

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“…Nevertheless, our data suggest that the efficacy of avelumab maintenance therapy for patients with SUC is relatively favorable regardless of the disease’s aggressiveness. Additionally, enfortumab vedotin monotherapy was recently reported as a third-line treatment for patients with metastatic SUC disease has certain effects ( 36 ). Thus, the key is to administer effective drugs sequentially, such as platinum-based chemotherapy, ICI therapy, and ADC therapy, without delay to patients with advanced SUC.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of avelumab maintenance therapy for advanced urothelial carcinoma with histologic subtype and divergent differentiation: a multicenter retrospective study conducted by the Uro-Oncology Group in Kyushu

Minato,

Furubayashi,

Tomoda

et al. 2024

Transl Androl Urol

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Background The subtype of urothelial carcinoma (SUC) has been known to possess morphological diversity for histologic subtype or divergent differentiation. However, the efficacy of avelumab against SUC remains unclear. Therefore, the effect of the treatment as well as the survival results of avelumab monotherapy were evaluated as a first-line therapeutic maintenance in patients with advanced SUC. Methods A retrospective analysis was conducted on consecutive patients from the Uro-Oncology Group in Kyushu study population with advanced lower and upper urinary tract cancer who underwent avelumab maintenance therapy without progression after first-line platinum-based chemotherapy. Patients with pure urothelial carcinoma (PUC) and SUC were comparatively analyzed based on objective response rate (ORR), disease control rate, progression-free survival (PFS), and overall survival (OS). Results Out of 49 recorded patients, 38 and 11 had PUC and SUC, respectively. The most common subtype element was glandular differentiation (n=5), followed by squamous differentiation (n=3), micropapillary (n=1), and plasmacytoid subtypes (n=1). The SUC and PUC groups had comparable ORR (0% vs. 2.6%, P>0.99) and disease control rates (54.5% vs. 44.7%, P=0.73). These patient groups also showed no significant difference in PFS (median 3.9 vs. 3.1 months, P=0.33) or OS (median 16.7 vs. 22.1 months, P=0.47). Conclusions The response of SUC and PUC to avelumab was comparable in patients with advanced lower and upper urinary tract cancer, indicating that avelumab maintenance therapy is also effective for SUC.

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Section: Discussionmentioning

confidence: 99%

Efficacy of avelumab maintenance therapy for advanced urothelial carcinoma with histologic subtype and divergent differentiation: a multicenter retrospective study conducted by the Uro-Oncology Group in Kyushu

Minato,

Furubayashi,

Tomoda

et al. 2024

Transl Androl Urol

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Nectin-4-directed antibody-drug conjugates (ADCs): Spotlight on preclinical and clinical evidence

Khosravanian,

Mirzaei,

Mer

et al. 2024

Life Sciences

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Clinical impact of a subtype of urothelial carcinoma in nonmuscle-invasive bladder cancer

Minato,

Yoshii,

Watanabe

et al. 2024

Japanese Journal of Clinical Oncology

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Objective This study aimed to assess the oncological outcomes of the subtype of urothelial carcinoma (SUC), including divergent differentiation and histologic subtype, in comparison with those of pure urothelial carcinoma (PUC) in nonmuscle-invasive bladder cancer. Methods We retrospectively evaluated patients who were initially treated with transurethral resection of the bladder tumor (TURBT) between March 2005 and August 2020 at a single institution. Patients with PUC and SUC were compared in terms of recurrence-free survival (RFS), progression-free survival (PFS), and overall survival (OS). Results Out of 853 enrolled patients, 783 (91.8%) and 70 (8.2%) had PUC and SUC, respectively. SUC presence was significantly associated with old age, tumor size (≥3 cm), higher pT1 rate, high grade, concomitant carcinoma in situ, and lymphovascular invasion. RFS rates after TURBT did not significantly differ between the PUC and SUC groups. With a median follow-up period of 66 months (interquartile range, 38–103 months), the rates and median time of progression to muscle invasion were 6.9% and 22.5 months in the PUC group, and 22.9% and 10.0 months in the SUC group. Moreover, the incidence of progression to metastasis was 4.6% and 15.7% in the PUC and SUC groups, respectively. The 5-year PFS rates (64.5% and 81.9%, P < .001) and 5-year OS rates (71.7% and 86.2%, P = .009) were lower in the SUC group than in the PUC group. On multivariate analysis, SUC presence independently predicted progression to muscle invasion and metastasis. Conclusion At initial TURBT diagnosis, we must pay more attention to higher progression risk of SUC than that of PUC in nonmuscle-invasive bladder cancer.

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Prognostic Impact of Histologic Subtype and Divergent Differentiation in Patients with Metastatic Urothelial Carcinoma Treated with Enfortumab Vedotin: A Multicenter Retrospective Study

Cited by 6 publications

References 29 publications

Efficacy of avelumab maintenance therapy for advanced urothelial carcinoma with histologic subtype and divergent differentiation: a multicenter retrospective study conducted by the Uro-Oncology Group in Kyushu

Efficacy of avelumab maintenance therapy for advanced urothelial carcinoma with histologic subtype and divergent differentiation: a multicenter retrospective study conducted by the Uro-Oncology Group in Kyushu

Nectin-4-directed antibody-drug conjugates (ADCs): Spotlight on preclinical and clinical evidence

Clinical impact of a subtype of urothelial carcinoma in nonmuscle-invasive bladder cancer

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