Department of Medicine, University of British Columbia, Vancouver, BC V6T 1Z3, Canada.
Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z3, Canada.
Curr Oncol. 2021 Sep 29;28(5):3812-3824. doi: 10.3390/curroncol28050325.
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).
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.
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).
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.
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。
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。
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）。
mBC 中超过 1.5 年的真实世界 mOS 是前所未有的，支持使用多线 PST。此外，免疫疗法在 1L 和 2L 环境中可能与化疗具有可比性。
