Real-world sequential treatment patterns and clinical outcomes among patients with advanced urothelial carcinoma in Japan

Yuki Kita, Hikari Otsuka, Katsuhiro Ito, Takuto Hara, Soichiro Shimura, Takashi Kawahara, Minoru Kato, Sojun Kanamaru, Koji Inoue, Hiroki Ito, Atsushi Igarashi, Tomokazu Sazuka, Dai Takamatsu, Kohei Hashimoto, Takashige Abe, Sei Naito, Yoshiyuki Matsui, Hiroyuki Nishiyama, Hiroshi Kitamura, Takashi Kobayashi*

*この論文の責任著者

研究成果: ジャーナルへの寄稿学術論文査読

12 被引用数 (Scopus)

抄録

Objectives: Immune checkpoint inhibitors and enfortumab vedotin have opened new avenues for sequential treatment strategies for locally advanced/metastatic urothelial carcinoma (la/mUC). In the pre-enfortumab vedotin era, many patients could not receive third-line treatment owing to rapid disease progression and poor general status. This study aimed to analyze real-world sequential treatment practices for la/mUC in Japan, with a focus on patients who do not receive third-line treatment. Methods: We analyzed data for 1023 la/mUC patients diagnosed between January 2020 and December 2021 at 54 institutions from a Japanese nationwide cohort. Results: At the median follow-up of 28.5 months, the median overall survival from first-line initiation for 905 patients who received systemic anticancer treatment was 19.1 months. Among them, 81% and 32% received second- and third-line treatment. Notably, 52% had their treatment terminated before the opportunity for third-line treatment. Multivariate logistic regression analysis revealed that low performance status (≥1), elevated neutrophil-to-lymphocyte ratio (≥3), and low body mass index (<21 kg/m2) at the start of first-line treatment were independent risk factors for not proceeding to third-line treatment (p = 0.0024, 0.0069, and 0.0058, respectively). In this cohort, 33% had one of these factors, 36% had two, and 15% had all three. Conclusions: This study highlights the high frequency of factors associated with poor tolerance to anticancer treatment in la/mUC patients. The findings suggest the need to establish optimal sequential treatment strategies, maximizing efficacy within time and tolerance constraints, while concurrently providing strong supportive care, considering immunological and nutritional aspects.

本文言語英語
ページ(範囲)552-559
ページ数8
ジャーナルInternational Journal of Urology
31
5
DOI
出版ステータス出版済み - 2024/05

ASJC Scopus 主題領域

  • 泌尿器学

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