Treatments Outcomes in Histological Variants and Non-Urothelial Bladder Cancer: Results of a Multicenter Retrospective Study

Introduction: Less than one-third of bladder cancers are non-pure urothelial carcinoma [with variant histological (VH) or non-urothelial carcinoma (non-UC)] for which no treatment guidelines are available. We aim to evaluate the efficacy of systemic treatments in VH or non-UC bladder cancers. Materi...

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Detalles Bibliográficos
Autores: Epaillard, Nicolas, Parent, Pauline, Loriot, Yohann, Lavaud, Pernelle, Vera-Cea, E-B., Martinez-Chanza, Nieves, Rodriguez-Vida, Alejo, Dumont, Clement, Lozano, Rebeca, Llácer, Casilda, Ratta, Raffaele, Oudard, Stephane, Thibault, Constance, Auclin, Edouard
Tipo de recurso: artículo
Fecha de publicación:2021
País:España
Institución:Instituto de Salud Carlos III (ISCIII)
Repositorio:Repisalud
Idioma:inglés
OAI Identifier:oai:repisalud.isciii.es:20.500.12105/18352
Acceso en línea:http://hdl.handle.net/20.500.12105/18352
Access Level:acceso abierto
Palabra clave:Urinary bladder neoplasms
Variant histology
Drug therapy
Immunotherapy
Mortality
Neoplasias de la vejiga urinaria
Quimioterapia
Inmunoterapia
Mortalidad
Humans
Female
Carcinoma, Transitional Cell
Urinary Bladder Neoplasms
Platinum
Confidence Intervals
Drug Therapy
Descripción
Sumario:Introduction: Less than one-third of bladder cancers are non-pure urothelial carcinoma [with variant histological (VH) or non-urothelial carcinoma (non-UC)] for which no treatment guidelines are available. We aim to evaluate the efficacy of systemic treatments in VH or non-UC bladder cancers. Materials: Multicenter retrospective analysis of patients treated for advanced or metastatic VH or non-UC bladder cancers. Primary endpoint was overall response rate (ORR) according to treatment line, regimen and histology subtype. Secondary endpoints were progression-free survival (PFS) and overall survival (OS). Results: Between 2005 and 2020, 46 patients from seven centers were included. The median age was 66 years (58.75; 74.75), 65.2% were male and 67.2% presented VH. At first line, the ORR for the entire population was 54.4% and median OS was 21.6 months (95% confidence interval [CI]: 14.2-38.6). The ORR of the 37 patients treated with chemotherapy at first line was 62.2% with median PFS and OS of 7.3 (95% CI: 4.5-8.6) and 21.6 months (95% CI: 14.2-35.7), respectively. Dose dense MVAC and platinum doublet chemotherapy had the highest ORR (71.4% and 65.2%). The 9 patients treated with immunotherapy at first line had an ORR of 22.2%, a median PFS of 3.3 months (95% CI:2.3-NR) and the median OS was not reached (95% CI:13.8-NR). Response to treatment varied depending on the histological sub-types and on the treatment type. Conclusion: Chemotherapy and immunotherapy have shown to be effective in VH or non-UC cancers, a rare histological subtype for which we currently have very little data in the literature.

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