转移性膀胱癌患者一线和二线姑息性全身治疗的生存结局。

Survival Outcomes Associated with First and Second-Line Palliative Systemic Therapies in Patients with Metastatic Bladder Cancer.

机构信息

Department of Medicine, University of British Columbia, Vancouver, BC V6T 1Z3, Canada.

Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z3, Canada.

出版信息

Curr Oncol. 2021 Sep 29;28(5):3812-3824. doi: 10.3390/curroncol28050325.

BACKGROUND

Real-world data on palliative systemic therapies (PST) in treating metastatic bladder cancer (mBC) is limited. This study investigates current trends in treating mBC with first- (1L) and second-line (2L) chemotherapy (CT) and immunotherapy (IT).

METHODS

A chart review was conducted on patients diagnosed with stage II-IV bladder cancer in 2014-2016. Survival outcomes were compared between chemotherapy, immunotherapy, and supportive care.

RESULTS

out of 297 patients, 77% were male. 44% had stage IV disease at diagnosis. Median age at metastasis was 73 years. 40% of patients received 1L PST and 34% received 2L PST. Median overall survival (mOS) was longer in those receiving PST versus no treatment ( < 0.001). Patients receiving CT and IT sequentially had the longest mOS (18.99 months). First-line IT and CT mOS from treatment start dates were 5.03 and 9.13 months, respectively ( = 0.81). Gemcitabine with cisplatin (8.88 months) or carboplatin (9.13 months) were the most utilized 1L chemotherapy regimens ( = 0.85). 2L IT and CT mOS from treatment start dates were 6.72 and 3.78 months, respectively ( = 0.15).

CONCLUSION

real-world mOS of >1.5 years in mBC is unprecedented and supports using multiple lines of PST. Furthermore, immunotherapy may be a comparable alternative to chemotherapy in both 1L and 2L settings.

背景

关于姑息性全身治疗（PST）治疗转移性膀胱癌（mBC）的真实世界数据有限。本研究调查了目前用一线（1L）和二线（2L）化疗（CT）和免疫疗法（IT）治疗 mBC 的趋势。

方法

对 2014-2016 年诊断为 II-IV 期膀胱癌的患者进行了病历回顾。比较了化疗、免疫治疗和支持治疗的生存结果。

结果

297 例患者中，77%为男性。44%在诊断时患有 IV 期疾病。转移时的中位年龄为 73 岁。40%的患者接受了 1L PST，34%的患者接受了 2L PST。与未接受治疗的患者相比，接受 PST 的患者的中位总生存期（mOS）更长（<0.001）。接受 CT 和 IT 序贯治疗的患者的 mOS 最长（18.99 个月）。从治疗开始日期计算的一线 IT 和 CT mOS 分别为 5.03 和 9.13 个月（=0.81）。吉西他滨联合顺铂（8.88 个月）或卡铂（9.13 个月）是最常用的 1L 化疗方案（=0.85）。从治疗开始日期计算的二线 IT 和 CT mOS 分别为 6.72 和 3.78 个月（=0.15）。