Neoadjuvant cisplatin-based chemotherapy followed by selective bladder preservation chemoradiotherapy (CRT) in muscle-invasive urothelial carcinoma of bladder (MIBC): A combined retrospective analysis of two prospective studies.

Authors

null

Joohyun Hong

Division of Hematology-Oncology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea

Joohyun Hong , Daeho Choi , Hyun Hwan Sung , Byong Chang Jeong , Se Hoon Park

Organizations

Division of Hematology-Oncology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea, Samsung Medical Center, Seoul, South Korea, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea, Samsung Medical Center, Sungkyunkwan Univ., Gangnam-Gu, South Korea

Research Funding

No funding received
None.

Background: Bladder preservation CRT in patients with a clinical complete response (cCR) following neoadjuvant cisplatin-based chemotherapy is one of the promising treatment strategies for MIBC. A combined analysis of raw data from two prospective phase II studies was performed to better evaluate the feasibility of selective bladder preservation CRT. Methods: The analysis was based on primary efficacy data from two independent studies, including 76 MIBC patients receiving neoadjuvant chemotherapy followed by bladder preservation CRT. The efficacy data included metastasis-free survival (MFS) and disease-free survival (DFS). For the present analysis, starting point of survivals was defined as the date of commencing CRT. Results: Sixty-four patients received gemcitabine/cisplatin (GC) combination chemotherapy in neoadjuvant setting, and 12 received nivolumab plus GC. After completion of planned neoadjuvant chemotherapy, 66 patients with a cCR and 10 who did not have a cCR but refused surgery were treated with CRT. With a median follow-up of 45 (95% CI, 41-48) months, a total of 39 recurrences was observed (51%): metastatic (n=28) and within the urinary tract (n=11). Median DFS or MFS was not reached. The 12- and 24-month DFS rates were 81% and 66%, respectively. MFS rates at 12- and 24-month were 87% and 75%, respectively. Both DFS (P=0.055) and MFS (P=0.014; HR 0.38; 95% CI, 0.17-0.85) appeared to be affected by the achievement of a cCR. Conclusions: The strategy of neoadjuvant chemotherapy followed by selective bladder preservation CRT based on the cCR is feasible in the treatment of MIBC.

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Abstract Details

Meeting

2023 ASCO Genitourinary Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session B: Prostate Cancer and Urothelial Carcinoma

Track

Urothelial Carcinoma,Prostate Cancer - Advanced

Sub Track

Therapeutics

Citation

J Clin Oncol 41, 2023 (suppl 6; abstr 496)

DOI

10.1200/JCO.2023.41.6_suppl.496

Abstract #

496

Poster Bd #

J18

Abstract Disclosures