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e16570 Background: EV has improved outcomes for patients with mUC whether used as monotherapy or in combination. Limited studies have explored EV's efficacy and toxicity using combined genomic data from multiple platforms. We explored the association of genomic alterations with clinical outcomes in patients with mUC receiving EV treated at a single institution. Methods: Clinical and genomic data from patients with mUC treated with EV at the Dana-Farber Cancer Institute was analyzed. Genomic data was obtained using the targeted Oncopanel platform. Overall survival (OS), progression-free survival (PFS), and toxicity-free survival (TFS) as well as objective response rate (ORR) and progressive disease (PD) as best response according to RECIST 1.1 criteria were studied. Patients were categorized based on genomic alterations employing log-rank tests and univariate Cox regression for OS, PFS, and TFS, and Fisher’s exact test for ORR and PD. Results: We identified 286 patients treated for advanced UC since the approval of EV in 2021, of whom 65 received EV monotherapy, had available genomic data and were included in our analysis. Two genomic regions, 1q23.3 and 9p21.3 were found of interest. 17% (N=11) exhibited gain or amplification at the 1q23.3 cytoband ( PVRL4 cytoband) while 35% (N=23) had a two-copy deletion or loss at 9p21.3 ( MTAP, CDKN2A/B cytoband). While none of the results were statistically significant, gain or amplification of 1q23.3 was associated with a trend towards worse OS (Table). ORR was 29% compared to 60% in those without, but this difference was not statistically significant (p.value = 0.62). Two-copy deletion or loss at 9p21.3 was associated with numerically longer OS (Table) ORR was 57% in patients with the alteration versus 50% in those without, and 9% versus 17% for PD, respectively. These differences also did not reach statistical significance (p.value = 0.46). Conclusions: Our study did not find significant correlations between specific somatic alterations and clinical outcomes in patients with metastatic UC treated with EV though limited by small sample size. The observed trends in alterations of 1q23.3 and 9p21.3 warrant further investigation in larger cohorts. Table: see text
Saliby et al. (Sat,) studied this question.