Survival Outcomes Associated with First and Second-Line Palliative Systemic Therapies in Patients with Metastatic Bladder Cancer
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Patient Population
2.2. Clinical Outcomes
2.3. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Appendix A
Agents | 1L (N = 297), n (%) | 2L (N = 116), n (%) |
---|---|---|
Chemotherapy | 110 (37.0) | 14 (12.1) |
Gemcitabine + Carboplatin | 53 (17.8) | 2 (5.2) |
Gemcitabine + Cisplatin | 36 (12.1) | 0 (0.0) |
Taxanes alone | 2 (0.7) | 7 (6.0) |
Other a | 19 (6.4) | 5 (4.3) |
Immunotherapy | 10 (3.4) | 25 (21.6) |
Atezolizumab | 4 (1.3) | 16 (13.8) |
Pembrolizumab | 4 (1.3) | 9 (7.8) |
Nivolumab | 2 (0.7) | 0 (0.0) |
No chemotherapy or immunotherapy | 177 (59.6) | 77 (66.4) |
Overall Survival | 1L IT N = 10 | 1L CT N = 110 | NT (Reference) N = 177 |
---|---|---|---|
mOS (95% CI; months) | 11.10 (7.79–NA) | 12.76 (10.95–15.59) | 3.16 (2.69–3.66) |
Log-rank test p-value | 0.0011 | <0.0001 | - |
HR (95% CI) | 0.291 (0.136–0.624) | 0.310 (0.239–0.402) | - |
Non-proportionality p-value | 0.2 | <0.0001 | - |
RMST (95% CI; months) | 19.686 (8.619–30.753) | 16.909 (14.373–19.445) | 5.462 (4.333–6.591) |
RMST difference (95% CI; months) | 14.224 (3.099–25.348) | 11.446 (8.670–14.222) | - |
RMST difference p-value | 0.012 | <0.0001 | - |
Overall Survival | 1L IT N = 10 | 1L CT (Reference) N = 110 |
---|---|---|
mOS (95% CI; months) | 5.03 (2.69–NA) | 9.13 (7.72–12.10) |
HR (95% CI) | 0.911 (0.422–1.967) | - |
Log-rank test p-value | 0.81 | - |
Overall Survival | GCarb N = 53 | GCis (Reference) N = 36 |
---|---|---|
mOS (95% CI; months) | 9.13 (6.69–14.30) | 8.88 (6.53–16.10) |
HR (95% CI) | 1.044 (0.668–1.633) | - |
Log-rank test p-value | 0.85 | - |
Overall Survival | 2L IT N = 25 | 2L CT N = 14 | 2L NT (Reference) N = 77 |
---|---|---|---|
mOS (95% CI; months) | 13.43 (9.10–18.82) | 9.34 (5.46–22.10) | 2.92 (1.85–4.82) |
Log-rank test p-value | 0.0047 | 0.1734 | - |
HR (95% CI) | 0.454 (0.275–0.749) | 0.639 (0.352–1.160) | - |
Non-proportionality p-value | 0.0002 | 0.0075 | - |
RMST (95% CI; months) | 15.95 (11.67–20.24) | 11.36 (6.66–17.87) | 7.65 (5.20–10.09) |
RMST difference (95% CI; months) | 8.31 (3.38–13.24) | 3.71 (−1.59–9.00) | - |
RMST difference p-value | 0.001 | 0.170 | - |
Overall Survival | 2L IT N = 25 | 2L CT (Reference) N = 14 |
---|---|---|
mOS (95% CI; months) | 6.72 (4.59–16.10) | 3.78 (1.99–NA) |
HR (95% CI) | 0.595 (0.293–1.209) | - |
Log-rank test p-value | 0.15 | - |
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Variable | Overall (N = 297) | |
---|---|---|
Gender (Male), number of patients | 228 (77%) | |
Age at metastasis in years, median (range) | 73 (36–98) | |
Grade, number of pts (%) | High | 272 (92%) |
Intermediate | 7 (3%) | |
Low | 5 (2%) | |
Unknown | 13 (4%) | |
Histology, number of pts (%) | Urothelial | 231 (78%) |
Squamous | 5 (2%) | |
Neuroendocrine | 14 (4%) | |
Glandular | 2 (<1%) | |
Mixed | 44 (15%) | |
Undifferentiated/other | 1 (<1%) | |
Lymphovascular invasion, number of pts (%) | 108 (36%) | |
Stage at initial diagnosis, number of pts (%) | II | 75 (25%) |
III | 91 (31%) | |
IV | 130 (44%) | |
Radical cystectomy, number of pts (%) | 137 (46%) | |
Radical radiotherapy, number of pts (%) | 27 (9%) | |
Prior curative chemotherapy use, number of pts (%) | 73 (25%) |
Overall Survival | IT Only N = 9 | CT Only N = 85 | Both CT & IT N = 26 | NT (Reference) N = 177 |
---|---|---|---|---|
mOS (95% CI; months) | 11.10 (7.79–NA) | 10.82 (9.26–13.59) | 18.99 (16.23–30.26) | 3.16 (2.69–3.66) |
Log-rank test p-value | 0.004 | <0.0001 | <0.0001 | - |
HR (95% CI) | 0.296 (0.13–0.67) | 0.362 (0.27–0.48) | 0.231 (0.15–0.37) | - |
Non-proportionality p-value | 0.29 | 0.0002 | 0.0001 | - |
RMST (95% CI; months) | 18.61 (6.31–30.91) | 15.07 (12.27–17.87) | 23.68 (18.73–28.63) | 5.46 (4.33–6.59) |
RMST difference (95% CI; months) | 13.15 (0.80–25.50) | 9.60 (6.58–12.62) | 18.22 (13.14–23.29) | - |
RMST difference p-value | 0.037 | <0.0001 | <0.0001 | - |
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Beigi, A.; Vafaei-Nodeh, S.; Huang, L.; Sun, S.Z.; Ko, J.J. Survival Outcomes Associated with First and Second-Line Palliative Systemic Therapies in Patients with Metastatic Bladder Cancer. Curr. Oncol. 2021, 28, 3812-3824. https://doi.org/10.3390/curroncol28050325
Beigi A, Vafaei-Nodeh S, Huang L, Sun SZ, Ko JJ. Survival Outcomes Associated with First and Second-Line Palliative Systemic Therapies in Patients with Metastatic Bladder Cancer. Current Oncology. 2021; 28(5):3812-3824. https://doi.org/10.3390/curroncol28050325
Chicago/Turabian StyleBeigi, Arshia, Saba Vafaei-Nodeh, Longlong Huang, Shaun Z. Sun, and Jenny J. Ko. 2021. "Survival Outcomes Associated with First and Second-Line Palliative Systemic Therapies in Patients with Metastatic Bladder Cancer" Current Oncology 28, no. 5: 3812-3824. https://doi.org/10.3390/curroncol28050325
APA StyleBeigi, A., Vafaei-Nodeh, S., Huang, L., Sun, S. Z., & Ko, J. J. (2021). Survival Outcomes Associated with First and Second-Line Palliative Systemic Therapies in Patients with Metastatic Bladder Cancer. Current Oncology, 28(5), 3812-3824. https://doi.org/10.3390/curroncol28050325