Impact of Squamous Histology on Clinical Outcomes and Molecular Profiling in Metastatic Urothelial Carcinoma Patients Treated With Immune Checkpoint Inhibitors or Enfortumab Vedotin

Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved..

INTRODUCTION: Urothelial carcinoma with squamous differentiation (UCS) is associated with increased resistance to chemotherapy, but outcomes associated with newer therapies approved in this space over the last 5 to 10 years are less well defined. We investigated clinical outcomes and molecular profiling of patients with UCS treated with an immune checkpoint inhibitor (ICI) and/or Enfortumab vedotin (EV).

PATIENTS AND METHODS: We undertook a retrospective analysis of UC patients treated with ICI and/or EV. Objective response rate (ORR), progression free survival (PFS) and overall survival (OS) were compared between pure UC (pUC) and UCS using X2 and log-rank tests, respectively. Prevalence of the most commonly detected somatic alterations were also compared between the 2 histologic subgroups.

RESULTS: A total of 160 patients (40 UCS, 120 pUC) were identified for this analysis. Among 151 patients treated with ICI (38 UCS, 113 pUC), UCS patients had a shorter mPFS (1.9 vs. 4.8 months, P < 0.01) and mOS (9.2 vs. 20.7 months, P < 0.01) compared to pUC. Among 37 patients treated with EV (12 UCS, 25 pUC), UCS patients had a lower ORR (17% vs. 70%, P < 0.01) and shorter mPFS (3.4 vs. 15.8 months, P < 0.01). UCS samples were enriched for CDKN2A, CDKN2B, PIK3CA, while pUC samples were enriched for ERBB2 alterations.

CONCLUSION: In this single-center retrospective analysis, patients with UCS had a distinct somatic genomic profile relative to patients with pUC. Patients with UCS also had inferior outcomes to ICIs and EV compared to patients with pUC.

Medienart:

E-Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - volume:21

Enthalten in:

Clinical genitourinary cancer - 21(2023), 5 vom: 05. Okt., Seite e394-e404

Sprache:

Englisch

Beteiligte Personen:

Jindal, Tanya [VerfasserIn]
Zhang, Li [VerfasserIn]
Deshmukh, Prianka [VerfasserIn]
Reyes, Kevin [VerfasserIn]
Chan, Emily [VerfasserIn]
Kumar, Vipul [VerfasserIn]
Zhu, Xiaolin [VerfasserIn]
Maldonado, Edward [VerfasserIn]
Feng, Stephanie [VerfasserIn]
Johnson, Michelle [VerfasserIn]
Angelidakis, Austin [VerfasserIn]
Kwon, Daniel [VerfasserIn]
Desai, Arpita [VerfasserIn]
Borno, Hala T [VerfasserIn]
Bose, Rohit [VerfasserIn]
Wong, Anthony [VerfasserIn]
Hong, Julian [VerfasserIn]
Carroll, Peter [VerfasserIn]
Meng, Maxwell [VerfasserIn]
Porten, Sima [VerfasserIn]
Aggarwal, Rahul [VerfasserIn]
Small, Eric J [VerfasserIn]
Fong, Lawrence [VerfasserIn]
Chou, Jonathan [VerfasserIn]
Friedlander, Terence [VerfasserIn]
de Kouchkovsky, Ivan [VerfasserIn]
Koshkin, Vadim S [VerfasserIn]

Links:

Volltext

Themen:

Antibody drug conjugate
DLE8519RWM
Enfortumab vedotin
Genetic markers
Immune Checkpoint Inhibitors
Immunotherapy
Journal Article
Research Support, Non-U.S. Gov't
Urinary bladder neoplasms

Anmerkungen:

Date Completed 02.10.2023

Date Revised 02.10.2023

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1016/j.clgc.2023.05.007

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM358180228