Abstract 237P
Background
Advanced urothelial cancer is an aggressive tumor type with high propensity of recurrence even after adequate surgical resection. The CheckMate-274 trial heralded a new era for resected urothelial cancer by the addition of adjuvant nivolumab which significantly reduced recurrence rate and prolonged survival. In the CheckMate-274 trial, 21% of the patients were upper urinary tract cancers (UTUC, including renal pelvis, collecting duct, ureter), reflecting the prevalence of UTUC in the western population. Asian patients have a significantly higher proportion of UTUC compared to western countries. Furthermore, in Asia, especially Taiwan, the etiology of urothelial cancers is likely distinct from western countries, with environmental factors as a main contributing factor. Therefore, the clinical efficacy of nivolumab in resected UTUC is relatively underinvestigated and warrants more research.
Methods
We retrospectively analyzed patients with resected urothelial cancer at the Taipei Veterans General Hospital, Taiwan, who received adjuvant nivolumab following adequate surgical resection. Clinical and pathological information were gathered and analyzed. We further collected genomic and clinical data for a further analysis of patients who had recurrence after completing adjuvant nivolumab.
Results
Our cohort included a total of 22 patients. 14 were female, 8 were male patients. 2 patients had bladder cancer, 4 patients had cancer of the ureter, and 16 patients had cancer of the renal pelvis (total of 20 UTUC). 3 patients were stage 2, 11 patients were stage 3, 8 patients were stage 4. With a median follow up time of 422.5 days, 7 patients had recurrence. In all 7 patients with recurrence, the median time to recurrence was 224 days (7.47 months). In the overall cohort, DFS was still not reached since the majority of patients were still in remission. We further performed genetic and pathological analysis for patients with recurrence.
Conclusions
Urothelial cancer is an aggressive disease with a dismal outcome. Adjuvant nivolumab significantly improved outcomes, but a portion of patients still present with rapid recurrence. Our study highlights the aggressiveness of UTUC which is highly prevalent in Asian countries.
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.
Resources from the same session
271P - Prostate cancer with histone modifier UTX mutations can benefit from olaparib
Presenter: NOBUHITO MURAMOTO
Session: Poster Display
Resources:
Abstract
272P - Comparison between MRI-targeted and standard biopsy for prostate cancer detection: A systematic review and meta-analysis
Presenter: Andree Kurniawan
Session: Poster Display
Resources:
Abstract
273P - The diagnostic performance of cognitive MRI-targeted biopsy in biopsy-naïve patients undergoing systematic 14-region 18-core biopsy: Do the three areas affect the results?
Presenter: Yuka Toyama
Session: Poster Display
Resources:
Abstract
274P - Index tumor location influencing early biochemical recurrence after radical prostatectomy in patients with negative surgical margins
Presenter: Jun Akatsuka
Session: Poster Display
Resources:
Abstract
275P - Prognosis of metastatic castration-resistant prostate cancer in response to chemotherapy and PSMA expression in circulating tumor cells
Presenter: Naoya Nagaya
Session: Poster Display
Resources:
Abstract
276P - Prognostic significance of p53 mutation in metastatic hormone-sensitive prostate cancer
Presenter: Lakshmi Kamala
Session: Poster Display
Resources:
Abstract
277P - Vasohibin-1 expression as a biomarker of aggressive growth in prostate ductal adenocarcinoma
Presenter: Murad Salomov
Session: Poster Display
Resources:
Abstract
278P - Full-coverage radiotherapy for prostate cancer patients with oligometastases
Presenter: Bichun Xu
Session: Poster Display
Resources:
Abstract
279P - Hypofractionated radiotherapy protocol implementation and early outcomes for prostate cancer patients: A single institution retrospective review
Presenter: Thu Nguyen
Session: Poster Display
Resources:
Abstract
280P - Radium-223 for patients with metastatic castration-resistant prostate cancer with symptomatic bone metastases progressing after first-line abiraterone or enzalutamide: One institutional experience
Presenter: Keng Man Chiang
Session: Poster Display
Resources:
Abstract