Mp53-13 Real-Word Outcomes of Maintenance Chemotherapy Versus Avelumab Therapy After First-Line Induction Chemotherapy for Advanced Urothelial Carcinoma: Yushima Study

You have accessJournal of UrologyBladder Cancer: Invasive V (MP53)1 May 2024MP53-13 REAL-WORD OUTCOMES OF MAINTENANCE CHEMOTHERAPY VERSUS AVELUMAB THERAPY AFTER FIRST-LINE INDUCTION CHEMOTHERAPY FOR ADVANCED UROTHELIAL CARCINOMA: YUSHIMA STUDY Keita Izumi, Hajime Tanaka, Masataka Yano, Ryoji Takazawa, Akira Noro, Tetsuro Tsukamoto, Junji Yonese, Tetsuo Okuno, Yasuyuki Sakai, Fumitaka Koga, Yukio Kageyama, Kazutaka Saito, and Yasuhisa Fujii Keita IzumiKeita Izumi , Hajime TanakaHajime Tanaka , Masataka YanoMasataka Yano , Ryoji TakazawaRyoji Takazawa , Akira NoroAkira Noro , Tetsuro TsukamotoTetsuro Tsukamoto , Junji YoneseJunji Yonese , Tetsuo OkunoTetsuo Okuno , Yasuyuki SakaiYasuyuki Sakai , Fumitaka KogaFumitaka Koga , Yukio KageyamaYukio Kageyama , Kazutaka SaitoKazutaka Saito , and Yasuhisa FujiiYasuhisa Fujii View All Author Informationhttps://doi.org/10.1097/01.JU.0001008784.37684.bd.13AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: To investigate and compare the efficacy of maintenance chemotherapy (mCx) and avelumab therapy (mAve) after first-line induction chemotherapy using a multi-institutional database. METHODS: We retrospectively reviewed 963 patients who underwent first-line chemotherapy for advanced urothelial carcinoma (aUC) at our institutions between 2012 and 2022. Among them, 141 patients who underwent maintenance therapy after showing SD or better response to the induction chemotherapy were analyzed; 90 and 51 patients received mCx and mAve, respectively. Cancer-specific survival (CSS) from the initiation of first-line chemotherapy was analyzed. For adjusting the risk factors included in Apolo's prognostic model, the cycles of induction chemotherapy and best overall response (BOR) to the induction chemotherapy, the propensity score matching was further performed between mAve and mCx groups. RESULTS: In the entire cohort, the median age was 70 and 108 patients (77%) were male. The number of induction cycles of the first line was 4/5/6 or more in 18 (12%)/ 5 (4%)/ 118 (84%) patients, respectively. BOR of the first-line therapy was CR/PR/SD in 9 (6%)/ 90 (64%)/ 42 (30%) patients, respectively. More patients in the mCx group received six or more courses of induction chemotherapy. During the median follow up of 21.7 months, 73 patients (52%) died of aUC overall. In the patients undergoing mCx and mAve, the median CSS was 27.4 months and not reached, respectively (p=0.044). In multivariable analysis, the use of mAve were independently associated with favorable CSS. In the propensity score matched cohorts, CSS was significantly longer in the patients undergoing mAve than those undergoing mCx (median, not reached versus 22.4 months, respectively; p=0.011, Fig. 1). CONCLUSIONS: Maintenance avelumab after the induction chemotherapy may contribute to the better CSS than maintenance chemotherapy in real-world practice. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e868 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Keita Izumi More articles by this author Hajime Tanaka More articles by this author Masataka Yano More articles by this author Ryoji Takazawa More articles by this author Akira Noro More articles by this author Tetsuro Tsukamoto More articles by this author Junji Yonese More articles by this author Tetsuo Okuno More articles by this author Yasuyuki Sakai More articles by this author Fumitaka Koga More articles by this author Yukio Kageyama More articles by this author Kazutaka Saito More articles by this author Yasuhisa Fujii More articles by this author Expand All Advertisement PDF downloadLoading ...