Abstract 3693
Background
Neoadjuvant chemotherapy (NAC) with cisplatin-based chemotherapy for muscle invasive bladder cancer (MIBC) has improves overall survival as compared to radical cystectomy (RC) alone. Our group has previously reported high risk features of MIBC that increase benefit of NAC. We report our institutional experience with NAC for patients with high-risk MIBC.
Methods
The records of consecutive high-risk, clinically node negative MIBC patients who underwent RC at our institution between 2005 and 2017 were reviewed. Pre-operative high-risk criteria included one or more of lymphovascular invasion, hydronephrosis, extravesical disease, and/or variant histology. Clinicopathologic and demographic information was collected, including eGFR and a previously validated frailty index. The primary outcomes were pathologic complete response (pCR=pT0N0M0) and downstaging to In our cohort (n = 674), 74.3% (n = 501) of patients received any NAC, most commonly dose dense MVAC (39.3%, n = 265) followed by gemcitabine/cisplatin (GC) (13.1%, n = 88), other cisplatin-based regimens (OCBR) (10.4%, n = 70), and non-cisplatin regimen (NCBR) (11.6%, n = 78) were used with similar frequency. The pCR rate was significantly lower without NAC at only 7.5% (n = 13, p < 0.01), while ddMVAC (30.2%, n = 80), GC (25%, n = 22), OCBR (25.7%, n = 18), and NCBR (23.1%, n = 18) all yielded similar results (p = 0.55). When controlling for age, baseline eGFR, frailty index, and clinical T stage the chemotherapeutic regimen was not significantly predictive of achieving The benefits of NAC for MIBC have been repeatedly demonstrated, however, the rate of pathologic CR in high-risk muscle invasive disease has not been reported in a large series. In our high risk MIBC group, NAC led to significant higher pCR rate as compared to upfront surgery. These findings will serve as a benchmark for future neoadjuvant studies for evaluation of novel regimens. The authors. Has not received any funding. M.T. Campbell: Honoraria (self), Advisory / Consultancy: Eisai; Honoraria (self), Advisory / Consultancy, Research grant / Funding (institution): EMD Serono; Honoraria (self), Advisory / Consultancy, Research grant / Funding (institution): Pfizer; Honoraria (self), Advisory / Consultancy: Genentech; Honoraria (self), Advisory / Consultancy: AstraZeneca; Advisory / Consultancy: Apricity health; Research grant / Funding (institution): Exelixis; Research grant / Funding (institution): Janssen; Non-remunerated activity/ies: BMS; Non-remunerated activity/ies: Roche; Non-remunerated activity/ies: Merck. A.Y. Shah: Honoraria (self), Research grant / Funding (institution): Eisai; Honoraria (self): Oncology Information Group; Honoraria (self): Roche Pharmaceuticals; Research grant / Funding (institution): BMS; Research grant / Funding (institution): EMD Serono. J. Gao: Travel / Accommodation / Expenses: AstraZeneca. A.O. Siefker-Radtke: Advisory / Consultancy, Travel / Accommodation / Expenses: Merck; Advisory / Consultancy, Travel / Accommodation / Expenses: Sharp & Dohme; Advisory / Consultancy, Travel / Accommodation / Expenses: Janssen; Advisory / Consultancy, Travel / Accommodation / Expenses: Nektar Therapeutics; Advisory / Consultancy, Travel / Accommodation / Expenses: Seattle Genetics; Advisory / Consultancy: Bavarian Nordic. C.P.N. Dinney: Advisory / Consultancy: FKD Therapies Oy; Advisory / Consultancy, Research grant / Funding (self): Merck; Advisory / Consultancy: Janssen; Advisory / Consultancy, Research grant / Funding (self): NCI; Research grant / Funding (self): The University of Eastern Finland, Faculty of Health Sciences (UEFHS). A.M. Kamat: Advisory / Consultancy: Photocure; Advisory / Consultancy: FKD; Advisory / Consultancy: Abbott Molecular; Advisory / Consultancy: Theralase; Advisory / Consultancy: Merck; Advisory / Consultancy: BMS; Advisory / Consultancy: Eisai; Advisory / Consultancy: BioClin Therapeutics; Advisory / Consultancy: Cold Genesys; Advisory / Consultancy: Roviant; Advisory / Consultancy: Sessen Bio; Advisory / Consultancy: Asieris; Advisory / Consultancy: Pfizer; Advisory / Consultancy: AstraZeneca; Advisory / Consultancy: US Biotest; Advisory / Consultancy: Ferring; Advisory / Consultancy: MDxHealth; Leadership role: IBCG; Advisory / Consultancy: TMC Innovation. N. Navai: Shareholder / Stockholder / Stock options: Allogene; Research grant / Funding (institution): Merck; Research grant / Funding (institution): Pacira. All other authors have declared no conflicts of interest.Results
Conclusions
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Funding
Disclosure
Resources from the same session
1802 - Evaluation of the anti-tumor efficacy and immune effects of N-809, a novel IL-15 superagonist/anti-PD-L1 bispecific agent
Presenter: Kristin Hicks
Session: Poster Display session 3
Resources:
Abstract
3190 - GI101, a novel triple-targeting bispecific CD80-IgG4-IL2variant fusion protein, elicits synergistic anti-tumor effects in preclinical models
Presenter: Jae Chan Park
Session: Poster Display session 3
Resources:
Abstract
4062 - Phase 1b, open-label, dose-escalation study of M9241 (NHS-IL12) plus avelumab in patients (pts) with advanced solid tumors
Presenter: Julius Strauss
Session: Poster Display session 3
Resources:
Abstract
5777 - THOR-707, a novel not-alpha IL-2, promotes all key immune system anti-tumoral actions of IL-2 without eliciting vascular leak syndrome (VLS)
Presenter: Marcos Milla
Session: Poster Display session 3
Resources:
Abstract
5047 - A phase I clinical trial of malignant pleural mesothelioma treated with locally delivered autologous anti-FAP-targeted CAR T-cells
Presenter: Alessandra Curioni
Session: Poster Display session 3
Resources:
Abstract
1679 - HPV16 E6-specific TCR-T armored with checkpoint blockade in the treatment of cervical cancer
Presenter: Paul Bryson
Session: Poster Display session 3
Resources:
Abstract
1133 - the Mutant Neoantigen Specific T Cell Is a Personalized Immunotherapy in Refractory Solid Tumor
Presenter: Qi Song
Session: Poster Display session 3
Resources:
Abstract
3338 - NY-ESO-1 and LAGE1A –an emerging target for cell therapies in solid tumours
Presenter: Ioanna Eleftheriadou
Session: Poster Display session 3
Resources:
Abstract
3089 - Targeting myeloid-derived suppressor cells and T cells: combination treatment with MTL-CEBPA and PD-1 antibody in a mouse syngeneic CT26 model
Presenter: Mikael Sodergren
Session: Poster Display session 3
Resources:
Abstract
5991 - Master Checkpoint Cbl-b Inhibition: Anti-tumor Efficacy in a Murine Colorectal Cancer Model Following siRNA-based Cell Therapy
Presenter: Kathrin Thell
Session: Poster Display session 3
Resources:
Abstract