Real-world perioperative systemic treatment patterns and outcomes in patients with urothelial carcinoma undergoing radical surgery - PubMed
3 days ago
- #urothelial carcinoma
- #perioperative systemic therapy
- #real-world data
- The study describes real-world perioperative systemic treatment patterns in Japanese patients with muscle-invasive urothelial carcinoma undergoing radical surgery.
- In muscle-invasive bladder cancer (MIBC), 57.6% received neoadjuvant chemotherapy (NAC), primarily gemcitabine-cisplatin, and 20.2% received adjuvant therapy, with increased NAC use over time.
- After adjuvant nivolumab approval (2022-2024), immunotherapy dominated adjuvant treatment in MIBC (75.4% nivolumab), while chemotherapy declined.
- In upper urinary tract urothelial carcinoma (UTUC), NAC was uncommon (5.5%), but adjuvant therapy was more frequent (15.7%), with limited adoption of adjuvant nivolumab (0.9%).
- Renal function influenced treatment choice: higher eGFR correlated with gemcitabine-cisplatin in NAC, while lower eGFR favored gemcitabine-carboplatin or nivolumab in adjuvant care.
- The study highlights distinct treatment patterns between MIBC and UTUC, with rapid uptake of adjuvant nivolumab in MIBC but minimal use in UTUC.