Journal article
Response and Survival with Immune Checkpoint Inhibitor in patients with advanced Urothelial Carcinoma and Histology Subtypes
Clinical genitourinary cancer, Vol.23(4), 102356
08/2025
DOI: 10.1016/j.clgc.2025.102356
PMID: 40378559
Abstract
Background
Immune Checkpoint Inhibitors (ICIs) are used for advanced urothelial carcinoma (aUC) in different settings. Most patients have pure UC (PUC) but about one-third have UC mixed with histology subtypes (HS). We examined outcomes in patients with HS aUC treated with ICI.
Methods
We included patients from 26 centers with PUC and any HS treated with ICI as 1st line [1L] upfront, maintenance avelumab [mAV], and ≥2nd line [2+L] therapy. We calculated overall and progression-free survival (OS, PFS) and observed response rate (ORR) from ICI start.
Results
We included 1511 patients; 752 1L, 609 2+L, 150 mAV. 1L: median OS was 15 (95%CI 12-17) months for patients with PUC (n=518), 15 (95%CI 8-23) months for squamous UC (n=85) [HR=1.2, (95%CI 0.8-1.6]), 11 (95%CI 6-17) months for micropapillary UC (n=46) (HR=1.2, [95% 0.8-1.8]), and 21 (95%CI 12-30) months in patients with UC mixed with ≥2 HS (n=30), (HR=0.9, [95%CI 0.5-1.4]). 2+L: median OS was 9 (95%CI 8-10) months for patients with PUC (n=441), 9 (95%CI 1-12) months for squamous UC (n=60) [HR=1.1, (95%CI 0.8-1.6]), 6 (95%CI 1-11) months for micropapillary UC (n=37) (HR=1.1, [95% 0.7-1.6]), and 7 (95%CI 4-10) months in patients with UC mixed with ≥2 HS (n=17), (HR=1.6, [95%CI 0.9-3.1]).
Conclusions
We found no significant OS difference between PUC and HS in patients with aUC treated with ICI monotherapy. Limitations include retrospective design, small sample size in several subsets, lack of randomization, no central imaging or pathology review, selection and confounding biases. Results are hypothesis-generating and need prospective validation.
Details
- Title: Subtitle
- Response and Survival with Immune Checkpoint Inhibitor in patients with advanced Urothelial Carcinoma and Histology Subtypes
- Creators
- Dimitra Rafailia BakaloudiRafee TalukderThomas EnrightJacob B. LearyDimitrios MakrakisLeonidas N. DiamantopoulosCharbel HobeikaVinay Mathew ThomasUmang SwamiRoubini ZakopoulouAristotelis BamiasJason R. BrownDavid J. PinatoCharles LatchfordTanya JindalVadim S. KoshkinJure MurgićMarija MiletićAna FrobeJeffrey JohnsonYousef ZakhariaAjjai AlvaCharles B. NguyenGavin HuiAlexandra DrakakiAlejo Rodriguez-VidaMacarena Rey-CárdenasDaniel CastellanoLucia Alonso BuznegoIgnacio DuranRafael Morales BarreraDavid MarmolejoRana R. McKayTyler F. StewartPedro BarataIlana B. EpsteinJoaquim BellmuntEvan Y. YuRuben RaychaudhuriRosa NadalFunda Vakar-LopezShilpa GuptaJonathan L. WrightAli Raza KhakiPetros Grivas
- Resource Type
- Journal article
- Publication Details
- Clinical genitourinary cancer, Vol.23(4), 102356
- DOI
- 10.1016/j.clgc.2025.102356
- PMID
- 40378559
- NLM abbreviation
- Clin Genitourin Cancer
- ISSN
- 1558-7673
- eISSN
- 1938-0682
- Publisher
- CIG MEDIA GROUP, LP; DALLAS
- Grant note
- KureIt Cancer ResearchCancer Treatment and Research Trust (CTRT)NIHR Imperial Biomedical Research Centre
DR Bakaloudi acknowledges support from KureIt Cancer Research. DJP acknowledges grant support from the Cancer Treatment and Research Trust (CTRT) and infrastructural support by the Imperial Experimental Cancer Medicine Centre and the NIHR Imperial Biomedical Research Centre. P Grivas, E. Yu, F. Vakar-Lopez and J Wright acknowledge the Seattle Translational Tumor Research program. This research did not receive any specific grant from funding agencies in the public, commercial, or non-profit sectors.
- Language
- English
- Electronic publication date
- 04/2025
- Date published
- 08/2025
- Academic Unit
- Hematology, Oncology, and Blood & Marrow Transplantation; Internal Medicine
- Record Identifier
- 9984811225302771
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