Neuroendocrine carcinoma of the urinary bladder: a large analysis of the French GETUG consortium

Date 22 October 2018
Event ESMO 2018 Congress
Session Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care
Topics Neuroendocrine Tumours
Presenter Marine Sroussi
Citation Annals of Oncology (2018) 29 (suppl_8): viii303-viii331. 10.1093/annonc/mdy283
Authors M. Sroussi1, M. Lorcet2, M.P. Tardy3, M. Guerin4, F. Estrade5, R. Delva6, P. Barthelemy7, P. Lavaud8, Y. Neuzillet9, N. Penel10, N. Houede11, D. Pouessel12, E. Mussat13, M. Gross Goupil14, H. Gauthier15, A. Gobert16, O. Huillard17, Y. Allory18, R. Elaidi1, S. Oudard1
  • 1Medical Oncology Department, HEGP - European Georges Pompidou Hospital, 75015 - Paris/FR
  • 2Medical Oncology Department, Léon Bérard Center, 69008 - Lyon/FR
  • 3Medical Oncology Department, Antoine Lacassagne Center, 6100 - Nice/FR
  • 4Medical Oncology Department, Paoli Calmettes Insitute, 13274 - Marseille/FR
  • 5Medical Oncology Department, Eugène Marquis Center, 35042 - Rennes/FR
  • 6Medical Oncology Department, Paul Papin Center, 49100 - Angers/FR
  • 7Medical Oncology Department, University Hospital Center, 67000 - Strasbourg/FR
  • 8Medical Oncology Department, Gustave Roussy Institute, 94800 - Villejuif/FR
  • 9Urology Department, Hopital Foch, 92151 - Suresnes/FR
  • 10General Oncology Department, Oscar Lambret Center, 59020 - Lille/FR
  • 11Medical Oncology Department, Gard Cancerology Department, 30029 - Nimes/FR
  • 12Medical Oncology Department, IUCT Oncopole, 31100 - Toulouse/FR
  • 13Medical Oncology Department, Henri Mondor Hospital, 94010 - Creteil/FR
  • 14Medical Oncology Department, St. André Hospital, 33000 - Bordeaux/FR
  • 15Medical Oncology Department, St Louis Hospital, 75010 - Paris/FR
  • 16Medical Oncology Department, Salpétrière Hospital, 75013 - Paris/FR
  • 17Medical Oncology Department, Cochin Hospital, 75679 - Paris/FR
  • 18Pathology Department, Curie Institute, 92210 - Saint-Cloud/FR

Abstract

Background

Neuroendocrine carcinoma of the urinary bladder (NCUB) is a rare malignancy, accounting for <1% of bladder cancers. Despite high sensitivity to platinum-based chemotherapy (CT), prognosis remains poor.

Methods

We retrospectively reviewed patients treated for NCUB in 18 French institutions to determine clinical/biologic characteristics, treatment efficacy and outcomes. Patient characteristics, treatment, follow-up and histological data were obtained from medical records. Tissue samples were pooled for further biological analyses.

Results

From 1992 to 2017, we reviewed 234 NCUB cases (84% male, age 31–93 [median 67] years, ECOG PS 0–3 [median 1]). Small cell carcinoma was found in 47% of patients and large cell carcinoma in 9%; urothelial carcinoma was present in 51% of patients. Hematuria (71%) and pain (19%) were the main symptoms. Main metastatic sites at diagnosis of metastatic disease were lymph node (76%), liver (42%), bone (42%), pelvic recurrence (33%), lung (19%) or brain (12%). Of 230 patients evaluable for staging at diagnosis, 168 had stage I–III disease: stage I (3%), II (20%), III (34%), not evaluable (16%). They were treated with neoadjuvant CT (49%; mainly based on a platinum-based agent + etoposide [85%]), surgery (74%), radiotherapy (24%), and/or adjuvant CT (24%). Ninety-nine patients (59%) had metastatic recurrence. Median time to relapse was 4 months, disease-free survival was 14 months (95% confidence interval [CI] 12–18]), and median overall survival (mOS) was 28 months (95% CI 20–32). Of 62 patients (27%) with metastases at diagnosis, first-line CT was based on platinum + etoposide (81%), platinum + other drug (15%), or taxanes (4%). For these patients, median progression-free survival (mPFS) was 7 months (95% CI 4–9). Only 28 patients had second-line CT with mPFS of 5.2 months and mOS of 11 months (95% CI 8–15).

Conclusions

This is, to our knowledge, the largest cohort of NCUB patients studied to date. Data emphasize the heterogeneity and aggressiveness of this disease. Future studies should investigate disease biology and the activity of targeted therapies in NCUB. Molecular characteristics based on tumor tissue analysis are underway.

Clinical trial identification

Legal entity responsible for the study

HEGP (European Georges Pompidou Hopsital).

Funding

Pierre Fabre.

Editorial Acknowledgement

Disclosure

All authors have declared no conflicts of interest.