Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, China.
Front Immunol. 2024 Nov 1;15:1479743. doi: 10.3389/fimmu.2024.1479743. eCollection 2024.
This study examined the efficacy and safety of neoadjuvant chemotherapy combined with immunotherapy in patients with muscle-invasive bladder cancer (MIBC).
This retrospective cohort study included patients diagnosed with MIBC at the First Affiliated Hospital of Soochow University between January 1, 2020, and December 31, 2023, assigned to either chemotherapy (gemcitabine with cisplatin) or combination (chemotherapy plus toripalimab or tislelizumab) groups based on the neoadjuvant treatment regimen. Key metrics, including pathological downstaging rate (PDR), pathological complete response rate (PCRR), and incidence and severity of adverse events (AEs), were compared between groups.
This study included 53 patients (mean age: 67.21 years). In the combination group, 14 patients (51.85%) achieved pathological complete remission (ypT0), and seven (25.93%) achieved partial remission (ypT1), resulting in a PDR and PCRR of 77.78 and 51.85%, respectively. In the chemotherapy group, six patients (23.08%) achieved complete remission, and five (19.23%) achieved partial remission, resulting in a PDR and PCRR of 42.31 and 23.08%, respectively. Differences between groups were statistically significant (p < 0.05). There were no significant differences in pathological downstaging or complete remission rates among subgroups in the combination group (p > 0.05). No serious allergic reactions or fatal AEs were detected in either group, with no grade 4 AEs. Grade 3 AE rates were 22.22 and 20.83% in the combination and chemotherapy groups, respectively, although non-significant (p > 0.05).
Neoadjuvant chemotherapy combined with immunotherapy had enhanced efficacy and manageable safety in patients with MIBC, suggesting its potential for integration into clinical practice.
本研究旨在评估新辅助化疗联合免疫治疗在肌层浸润性膀胱癌（MIBC）患者中的疗效和安全性。
本回顾性队列研究纳入了 2020 年 1 月 1 日至 2023 年 12 月 31 日期间在苏州大学第一附属医院诊断为 MIBC 的患者，根据新辅助治疗方案分为化疗组（吉西他滨联合顺铂）或联合组（化疗加替雷利珠单抗或特瑞普利单抗）。比较两组的关键指标，包括病理降期率（PDR）、病理完全缓解率（PCRR）以及不良事件（AE）的发生率和严重程度。
本研究共纳入 53 例患者（平均年龄：67.21 岁）。联合组 14 例（51.85%）患者达到病理完全缓解（ypT0），7 例（25.93%）患者达到部分缓解（ypT1），PDR 和 PCRR 分别为 77.78%和 51.85%。化疗组 6 例（23.08%）患者完全缓解，5 例（19.23%）患者部分缓解，PDR 和 PCRR 分别为 42.31%和 23.08%。两组间差异有统计学意义（p<0.05）。联合组亚组间病理降期或完全缓解率无显著差异（p>0.05）。两组均未发生严重过敏反应或致命 AE，无 4 级 AE。联合组和化疗组 3 级 AE 发生率分别为 22.22%和 20.83%，但差异无统计学意义（p>0.05）。
新辅助化疗联合免疫治疗在 MIBC 患者中具有增强的疗效和可管理的安全性，提示其在临床实践中的应用潜力。
