@article{364a6d9cb3d4472cbbb896a1cb030b55,
title = "Comparative effectiveness of neoadjuvant chemotherapy in bladder and upper urinary tract urothelial carcinoma",
abstract = "Objective: To assess the differential response to neoadjuvant chemotherapy (NAC) in patients with urothelial carcinoma of the bladder (UCB) compared to upper tract urothelial carcioma (UTUC) treated with radical surgery. Patients and Methods: Data from 1299 patients with UCB and 276 with UTUC were obtained from multicentric collaborations. The association of disease location (UCB vs UTUC) with pathological complete response (pCR, defined as a post-treatment pathological stage ypT0N0) and pathological objective response (pOR, defined as ypT0-Ta-Tis-T1N0) after NAC was evaluated using logistic regression analyses. The association with overall (OS) and cancer-specific survival (CSS) was evaluated using Cox regression analyses. Results: A pCR was found in 250 (19.2%) patients with UCB and in 23 (8.3%) with UTUC (P < 0.01). A pOR was found in 523 (40.3%) patients with UCB and in 133 (48.2%) with UTUC (P = 0.02). On multivariable logistic regression analysis, patients with UTUC were less likely to have a pCR (odds ratio [OR] 0.45, 95% confidence interval [CI] 0.27–0.70; P < 0.01) and more likely to have a pOR (OR 1.57, 95% CI 1.89–2.08; P < 0.01). On univariable Cox regression analyses, UTUC was associated with better OS (hazard ratio [HR] 0.80, 95% CI 0.64–0.99, P = 0.04) and CSS (HR 0.63, 95% CI 0.49–0.83; P < 0.01). On multivariable Cox regression analyses, UTUC remained associated with CSS (HR 0.61, 95% CI 0.45–0.82; P < 0.01), but not with OS. Conclusions: Our present findings suggest that the benefit of NAC in UTUC is similar to that found in UCB. These data can be used as a benchmark to contextualise survival outcomes and plan future trial design with NAC in urothelial cancer.",
keywords = "#BladderCancer, #blcsm, #uroonc, #utuc, bladder cancer, neoadjuvant chemotherapy, response, survival, upper tract urothelial carcinoma",
author = "David D{\textquoteright}Andrea and Surena Matin and Black, {Peter C.} and Petros, {Firas G.} and Homayoun Zargar and Dinney, {Colin P.} and Cookson, {Michael S.} and Wassim Kassouf and Dall'Era, {Marc A.} and McGrath, {John S.} and Wright, {Jonathan L.} and Thorpe, {Andrew C.} and Morgan, {Todd M.} and Holzbeierlein, {Jeffrey M.} and Bivalacqua, {Trinity J.} and Sridhar, {Srikala S.} and Scott North and Barocas, {Daniel A.} and Yair Lotan and Stephenson, {Andrew J.} and {van Rhijn}, {Bas W.} and Spiess, {Philippe E.} and Siamak Daneshmand and Shariat, {Shahrokh F.}",
note = "Funding Information: We thank Associate Professor Sonja Zehetmayer (Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria) for supervising the statistical analyses. Funding Information: David D{\textquoteright}Andrea, Firas G. Petros, Homayoun Zargar, Colin P. Dinney, John S. McGrath, Jonathan L. Wright, Andrew C. Thorpe, Todd M. Morgan, Jeffrey M. Holzbeierlein, Trinity J. Bivalacqua, Srikala S. Sridhar, Daniel A. Barocas, Andrew J. Stephenson, and Bas W. van Rhijn have nothing to disclose. Surena Matin reports personal fees from QED‐Medical, Taris Bio, Urogen, outside the submitted work. Wassim Kassouf reports personal fees from Sesen Bio, Roche, Merck, Ferring, Janssen, outside the submitted work. Marc A. Dall'Era reports personal fees from Janssen, Photocure, grants from Movember, Tempus, outside the submitted work. Philippe E. Spiess reports other from NCCN Bladder and Penile Cancer panel, outside the submitted work. Yair Lotan reports grants from MdxHealth, Pacific Edge, Cepheid, and Decipher Biosciences, personal fees from Nucleix, personal fees from Photocure, Merck, AstraZeneca, and Fergene, during the conduct of the study. Peter C. Black reports other from Janssen, Merck, Roche/Genentech, BMS, Urogen, Asieris, EMD Serono, Bayer, TerSera, Astellas, AbbVie, AstraZeneca, Ferring, Fergene, H3‐Biomedicine, Sanofi, Biosyent, and Pfizer, grants from iProgen, non‐financial support from Decipher Biosciences, outside the submitted work. Michael S Cookson reports personal fees from Fallon Medica (Bayer), Cancer Expert Now (CEN), TesoRx Pharma, LLC, Ferring Pharmaceuticals, Inc., Myovant Sciences, Inc., Bayer Healthcare Pharmaceuticals, Inc., Janssen Scientific Affairs, LLC, Bayer Healthcare Pharmaceuticals, Inc., Merck & Company, Inc., Astellas Pharma US, Inc., Eichhorn and Eichhorn, LLP, Precision Biopsy, Inc., Janssen Scientific Affairs, LLC, Janssen Pharmaceuticals, Inc., grants from MDXHealth, Bayer Pharma AG, Bayer HealthCare AG, FKD Therapies Oy, Medpace, Inc., Quintiles, Inc., outside the submitted work. Siamak Daneshmand reports personal fees from Aduro Biotech, Allergan, Bristol‐Myers Squibb, Janssen, Johnson & Johnson, Nucleix, Olympus, Pacific Edge, Seattle Genetics, Spectrum Pharmaceuticals, Ferring, Taris, Photocure, outside the submitted work. Shahrokh F. Shariat reports personal fees from Astellas, Astra Zeneca, Bayer, BMS, Cepheid, Ferring, Ipsen, Janssen, Lilly, MSD, Olympus, Pfizer, Pierre Fabre, Roche, Sanochemia, Sanofi, Wolff, outside the submitted work; in addition he has the following patents Method to determine prognosis after therapy for prostate cancer; Granted 2002‐09‐06, Method to determine prognosis after therapy for bladder cancer; Granted 2003‐06‐19, Prognostic methods for patients with prostatic disease; Granted 2004‐08‐05, Soluble Fas urinary marker for the detection of bladder transitional cell carcinoma; Granted 2010‐07‐20. Publisher Copyright: {\textcopyright} 2020 The Authors BJU International Published by John Wiley & Sons Ltd on behalf of BJU International.",
year = "2021",
month = may,
doi = "10.1111/bju.15253",
language = "English (US)",
volume = "127",
pages = "528--537",
journal = "BJU International",
issn = "1464-4096",
publisher = "Wiley-Blackwell",
number = "5",
}