The prognostic significance of histologic variant on survival outcomes in patients with metastatic urothelial carcinoma receiving immune checkpoint inhibitor therapy
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...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-09-01
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| Series: | BMC Cancer |
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| Online Access: | https://doi.org/10.1186/s12885-023-11398-w |
| _version_ | 1797452285730619392 |
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| author | 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 |
| author_facet | 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 |
| author_sort | Tsung-Han Tsai |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-09T15:06:31Z |
| format | Article |
| id | doaj.art-10619625828044718e74366ce2c048cc |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-03-09T15:06:31Z |
| publishDate | 2023-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj.art-10619625828044718e74366ce2c048cc2023-11-26T13:35:47ZengBMCBMC Cancer1471-24072023-09-0123111010.1186/s12885-023-11398-wThe prognostic significance of histologic variant on survival outcomes in patients with metastatic urothelial carcinoma receiving immune checkpoint inhibitor therapyTsung-Han Tsai0Po-Jung Su1Shih-Yu Huang2Ming-Chun Kuo3Chang-Ting Lin4Chia-Che Wu5Hao-Lun Luo6Chien-Hsu Chen7Chih-Chi Chou8Ting-Ting Liu9Chun-Chieh Huang10Kai-Lung Tsai11Yu-Li Su12Division of Hematology Oncology, Department of Internal Medicine, College of Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung UniversityDivision of Hematology Oncology, Chang Gung Memorial Hospital at Linkou and College of Medicine, Chang Gung UniversityDivision of Hematology Oncology, Department of Internal Medicine, College of Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung UniversityDivision of Hematology Oncology, Department of Internal Medicine, College of Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung UniversityDivision of Hematology Oncology, Department of Internal Medicine, College of Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung UniversityDivision of Hematology Oncology, Department of Internal Medicine, College of Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung UniversityDepartment of Urology, College of Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung UniversityDepartment of Urology, College of Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung UniversityDepartment of Pathology, College of Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung UniversityDepartment of Pathology, College of Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung UniversityDepartment of Radiation Oncology, College of Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung UniversityDepartment of Colorectal Surgery, College of Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung UniversityDivision of Hematology Oncology, Department of Internal Medicine, College of Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung UniversityAbstract 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.https://doi.org/10.1186/s12885-023-11398-wMetastatic urothelial carcinomaVariant histologyImmune checkpoint inhibitorsReal-world data |
| spellingShingle | 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 The prognostic significance of histologic variant on survival outcomes in patients with metastatic urothelial carcinoma receiving immune checkpoint inhibitor therapy BMC Cancer Metastatic urothelial carcinoma Variant histology Immune checkpoint inhibitors Real-world data |
| title | The prognostic significance of histologic variant on survival outcomes in patients with metastatic urothelial carcinoma receiving immune checkpoint inhibitor therapy |
| title_full | The prognostic significance of histologic variant on survival outcomes in patients with metastatic urothelial carcinoma receiving immune checkpoint inhibitor therapy |
| title_fullStr | The prognostic significance of histologic variant on survival outcomes in patients with metastatic urothelial carcinoma receiving immune checkpoint inhibitor therapy |
| title_full_unstemmed | The prognostic significance of histologic variant on survival outcomes in patients with metastatic urothelial carcinoma receiving immune checkpoint inhibitor therapy |
| title_short | The prognostic significance of histologic variant on survival outcomes in patients with metastatic urothelial carcinoma receiving immune checkpoint inhibitor therapy |
| title_sort | prognostic significance of histologic variant on survival outcomes in patients with metastatic urothelial carcinoma receiving immune checkpoint inhibitor therapy |
| topic | Metastatic urothelial carcinoma Variant histology Immune checkpoint inhibitors Real-world data |
| url | https://doi.org/10.1186/s12885-023-11398-w |
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