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
298P - Managing locally advanced cervical cancer: Insights from a tertiary care center and a 3-year follow-up on outcomes
Presenter: Ambedkar Yadala
Session: Poster Display
Resources:
Abstract
299P - Sexual dysfunction assessment in longterm survivors of carcinoma cervix using LENT SOMA scale
Presenter: Niharika Sethi
Session: Poster Display
Resources:
Abstract
300P - Assessing ovarian function in Vietnamese cervical cancer patients who underwent ovary transposition prior to pelvic radiation therapy
Presenter: Cuong Nguyen
Session: Poster Display
Resources:
Abstract
301P - Correlation between cervical cancer recurrence after radiation therapy and vaginal microbiome
Presenter: Xiaoxian Xu
Session: Poster Display
Resources:
Abstract
302P - Expression of ERCC4 gene and its correlation with clinical and pathological parameters in cervical cancer
Presenter: Himanshu Mishra
Session: Poster Display
Resources:
Abstract
303P - Prognostic value of body composition and systemic inflammatory markers in patients with locally advanced cervical cancer following chemoradiotherapy
Presenter: Hui Guo
Session: Poster Display
Resources:
Abstract
305P - A real-world multicenter cohort study of lenvatinib (LEN) plus pembrolizumab (PEM) in Japanese patients with endometrial cancer: Interim analysis of GOGO-EM4 study
Presenter: Yoshikazu Nagase
Session: Poster Display
Resources:
Abstract
306P - Adjuvant treatment and impact on relapse in stage IA uterine papillary serous and clear cell carcinomas: A single center retrospective study
Presenter: Sachin Khurana
Session: Poster Display
Resources:
Abstract
307P - Hormonal therapy vs combination chemotherapy in metastatic leiomyosarcomas: A systematic review
Presenter: Patricia Angel
Session: Poster Display
Resources:
Abstract
309P - Expression of estrogen receptor is a negative predictive biomarker for immunotherapy with lenvatinib plus pembrolizumab for advanced endometrial cancer with pMMR
Presenter: Hiroyuki Fujii
Session: Poster Display
Resources:
Abstract