Shindo Tetsuya, Hashimoto Kohei, Kenuka Toshiki, Miyamoto Shintaro, Hiyama Yoshiki, Fukuta Fumimasa, Kunishima Yasuharu, Okada Manabu, Matsukawa Masanori, Kato Ryuichi, Senda Masaya, Wanifuchi Atsushi, Sato Shunsuke, Kobayashi Ko, Tanaka Toshiaki, Masumori Naoya
Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan.
Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan.
J Geriatr Oncol. 2025 Mar;16(2):102183. doi: 10.1016/j.jgo.2024.102183. Epub 2025 Jan 9.
We aimed to evaluate the efficacy and safety of enfortumab vedotin therapy for a cohort of older Japanese patients with metastatic urothelial carcinoma compared to younger patients.
We retrospectively evaluated patients with metastatic urothelial carcinoma treated with enfortumab vedotin and recruited between April 2019 and February 2023. Older patients were defined as being ≥75 years old. Efficacy was evaluated by comparing overall survival, progression-free survival, and objective response rates between groups. Adverse events and relative dose intensity were also compared. Moreover, the prognostic factor for overall survival in the entire cohort was evaluated using multivariate analysis.
Of the 57 patients treated with enfortumab vedotin, 37 were younger and 20 were older, (median ages of 67.6 and 79.2, respectively). Median overall survival in older and younger patients was 407 and 365 days, respectively (P = 0.48). The objective response rate was 60.0 % and 54 % (P = 0.68) and median progression-free survival 228 and 223 days in older and younger patients, respectively (P = 0.76). Adverse events were equivalent between groups except for liver dysfunction, which frequently occurred in younger patients. The dose intensity for the older and younger patients did not differ (65.7 % vs. 63.5 %, P = 0.37, respectively). In multivariate analysis, neutrophil-to-lymphocyte ratio of 3 or more was the only risk factor for worse overall survival in the entire cohort (P = 0.04).
Our data demonstrated that enfortumab vedotin therapy can benefit older patients with metastatic urothelial carcinoma equivalent to younger patients without compromising safety profiles.
我们旨在评估与年轻患者相比，安维汀（enfortumab vedotin）疗法对一组老年日本转移性尿路上皮癌患者的疗效和安全性。
我们回顾性评估了2019年4月至2023年2月期间接受安维汀治疗的转移性尿路上皮癌患者。老年患者定义为年龄≥75岁。通过比较两组之间的总生存期、无进展生存期和客观缓解率来评估疗效。还比较了不良事件和相对剂量强度。此外，使用多变量分析评估整个队列中总生存期的预后因素。
在接受安维汀治疗的57例患者中，37例为年轻患者，20例为老年患者（中位年龄分别为67.6岁和79.2岁）。老年和年轻患者的中位总生存期分别为407天和365天（P = 0.48）。客观缓解率分别为60.0%和54%（P = 0.68），老年和年轻患者的中位无进展生存期分别为228天和223天（P = 0.76）。除肝功能障碍（在年轻患者中经常发生）外，两组之间的不良事件相当。老年和年轻患者的剂量强度没有差异（分别为65.7%和63.5%，P = 0.37）。在多变量分析中，中性粒细胞与淋巴细胞比值≥3是整个队列中总生存期较差的唯一危险因素（P = 0.04）。
我们的数据表明，安维汀疗法可使老年转移性尿路上皮癌患者受益，效果与年轻患者相当，且不影响安全性。
