Data from a real-world analysis of survival outcomes demonstrated a significant improvement in overall survival (OS) among patients with muscle-invasive bladder cancer (MIBC); however, similar survival gains were not seen for patients with metastatic urothelial carcinoma (UC). Sunil Samnani, MBBS, of the Tom Baker Cancer Centre in Alberta, Canada, presented these findings at the 2021 Genitourinary Cancers Symposium.

The study evaluated survival trends in a pool of 572 patients with MIBC or mUC. The study population, derived from 3 cancer centers in Canada, included consecutive patients who received platinum-based chemotherapy between January 2005 and January 2018. The investigators excluded patients who received frontline treatment in a clinical trial.

Patients were categorized based on the year of diagnosis at presentation. The first time period was defined as January 2005 to January 2011 (time period 1 [TP1]); the second, January 2012 to December 2018 (time period 2 [TP2]). There were 65 patients diagnosed with MIBC and 205 patients diagnosed with metastatic UC in TP1. TP2 included 131 and 171 MIBC and metastatic UC diagnoses, respectively.

The median disease-free survival (DFS) significantly improved for patients with MIBC who were treated during TP2 vs TP1. The DFS for patients with MIBC who sought treatment during TP1 was 21.0 months; this number increased to 38.9 months in TP2 (HR, 0.58; 95% CI, 0.38-0.90; P =.016). A similar improvement in OS was seen between TP1 and TP2 (33.8 months to 82.8 months; HR, 0.47; 95% CI, 0.30-0.74; P =.001).


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The researchers said the survival improvements in MIBC were likely due to the standardization of perioperative chemotherapy protocols and improvements in surgical techniques. Data from a multivariable analysis showed that an earlier year of diagnosis and an Eastern Cooperative Oncology Group (ECOG) status of 2 or higher were independently associated with poor outcomes in MIBC (P =0.016 and P =0.008, respectively).

Among patients with metastatic UC, there was no significant improvement in progression-free survival (TP1, 5.1 months vs TP2, 6.2 months; HR, 1.14; P =.225) or OS (TP1, 9.4 months vs TP2, 10.5 months; HR, 1.14; P =.253) between treatment periods.

The researchers noted that novel therapies such as immune checkpoint inhibitors were only approved in metastatic UC in 2017; therefore, future analyses should explore outcomes in patients with treated from 2017 onwards.

Disclosures: Some of the study authors disclosed financial relationships with the pharmaceutical industry and/or the medical device industry. For a full list of disclosures, please refer to the original study.

Reference

Samnani S, Veitch ZWN, Kaiser J, et al. Trends over time in survival in patients with urothelial carcinoma in the real-world: a multicenter analysis. Presented at: 2020 Genitourinary Cancers Symposium; February 11-13, 2021. Abstract 412.

This article originally appeared on Cancer Therapy Advisor

Source: Renal & Urology News

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