221P - Comparative analysis of first-line immune checkpoint inhibitor versus carboplatin-based chemotherapy for cisplatin-ineligible metastatic urothelial carcinoma: A multicenter, retrospective real-world evidence

Background

First-line immune checkpoint inhibitor (ICI) for cisplatin-ineligible metastatic urothelial carcinoma patients has been approved by FDA and EMA. However, there is still a lack of evidence to directly compare treatment efficacy between ICI and conventional carboplatin-based chemotherapy. Here we conduct a retrospective analysis to compare the survival outcome between ICI and carboplatin treatment.

Methods

The study enrolled 130 metastatic urothelial carcinoma patients who underwent first-line ICI or carboplatin-based chemotherapy at Kaohsiung and Linko Chang Gung Memorial Hospital between May 2001 and Jun 2019. Kaplan-Meier analyses and Cox proportional regression models were used for univariate and multivariate survival analyses.

Results

In total, there were 44 patients (34%) in the ICI group and 86 patients (66%) in the carboplatin group. The median OS was insignificantly different between ICI and carboplatin groups, accounting for 11.1 and 9.5 months (p = 0.46), respectively. The median PFS in ICI and carboplatin groups were 2.5 and 3.7 months, respectively (p = 0.92). On subgroup analysis, OS was significantly worse for ICI treatment in patients with elevated pretreatment white blood cell count (WBC ≥ 10000 × 10³/μL) compared with those on carboplatin group (HR 2.41, 95% CI 1.1 – 5.25, p = 0.03).

Conclusions

In this real-world data analysis, we didn’t show significant survival difference in first-line treatment with ICI and carboplatin-based chemotherapy.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.