Prognostic Impact of Skeletal Muscle Radiodensity in Advanced Urothelial Carcinoma Undergoing Avelumab Maintenance Therapy.

Background/Aim: best supportive care in patients with advanced urothelial carcinoma who attained disease control after platinum-based chemotherapy in the JAVELIN Bladder 100 trial. Although patients generally tolerate avelumab maintenance therapy, some patients experience rapid progression and prognostic factors are not well established. Patients and Methods: In this retrospective study, we investigated the prognostic significance of computed tomography-derived body composition indicators in 57 patients with advanced urothelial carcinoma who received avelumab maintenance therapy after first-line platinum-based chemotherapy. These patients were from within a cohort of 85 patients who underwent first-line platinum-based chemotherapy. Patients were divided into two groups based on a low or high skeletal muscle radiodensity (SMD). Prognostic factors were determined using univariate and multivariate analyses. Results: 16.7 months, respectively. In a Cox proportional hazards model, only low SMD indicated a worse prognosis for PFS [hazard ratio (HR)=2.07, 95% confidence interval (CI)=1.06-4.04], while low SMD plus a high neutrophil-lymphocyte ratio were independent predictors for worse OS (HR=2.29, 95%CI=1.04-5.05 and HR=2.44, 95%CI=1.11-5.37, respectively). Conclusion: SMD is a potential prognostic factor for advanced urothelial carcinoma cases undergoing avelumab maintenance therapy.