Abstract 314P
Background
Upper tract urothelial carcinomas (UTUC) are rare, with poorer stage-for-stage prognosis than bladder cancer. The POUT study showed that adjuvant platinum-based therapy significantly improves disease-free survival (DFS). The role of tislelizumab combined with chemotherapy as adjuvant therapy in UTUC is unknown. The aim of this study was to evaluate the efficacy of adjuvant tislelizumab combined with chemotherapy in patients with UTUC treated with radical nephroureterectomy.
Methods
This single-center, real-world study retrospectively analyzed the data from 66 patients with muscle-invasive UTUC who had radical nephroureterectomy (RNU) at a hospital between April 1, 2020, and April 1, 2024. Among the 66 patients, 29 received adjuvant therapy of chemotherapy (group A) within 90 days after RNU and 37 underwent tislelizumab combined with chemotherapy (group B). No patients receive neoadjuvant therapy. In both groups, adjuvant therapy was administered every 3 weeks after surgery until the first recurrence, first metastasis, or death from any cause, whichever occurred first. The patients were followed up telephonically and through outpatient visits to record and evaluate their DFS and treatment-related adverse events (TRAEs).
Results
The median follow-up duration was 14.4 (8.3-23.6) months. After adjusting for age, sex, tumor location, multifocality, tumor grade, presence of lymphovascular invasion, surgical margin, through propensity-scored matching. The median DFS of group A was 20.5 [95% confidence interval (CI), 9.6-31.4] months, while the median DFS of the group B has not yet reached [hazard ratio (HR) 0.426 (95% CI, 0.192-0.943); p=0.030]. The incidence of TRAEs was 89.2% in group A and 97.1% in group B. All TRAEs were consistent with those reported in previous studies, and there was no treatment-related death.
Conclusions
Tislelizumab combined with chemotherapy shows better clinical efficacy than chemotherapy alone in the adjuvant treatment of patients with UTUC undergoing radical surgery, significantly improves DFS and displaying a manageable safety profile. However, prospective clinical trials are still needed to clarify this issue.
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.