Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Jul 31;13(7):1118-1126.
doi: 10.21037/tau-24-53. Epub 2024 Jul 12.

Efficacy of avelumab maintenance therapy for advanced urothelial carcinoma with histologic subtype and divergent differentiation: a multicenter retrospective study conducted by the Uro-Oncology Group in Kyushu

Akinori Minato  1 , Nobuki Furubayashi  2 , Toshihisa Tomoda  3 , Yoshifumi Hori  4 , Keijiro Kiyoshima  5 , Takahito Negishi  2 , Kentaro Kuroiwa  4 , Ikko Tomisaki  1 , Kenichi Harada  1 , Motonobu Nakamura  2 , Naohiro Fujimoto  1
Affiliations

Efficacy of avelumab maintenance therapy for advanced urothelial carcinoma with histologic subtype and divergent differentiation: a multicenter retrospective study conducted by the Uro-Oncology Group in Kyushu

Akinori Minato et al. Transl Androl Urol. .

Abstract

Background: The subtype of urothelial carcinoma (SUC) has been known to possess morphological diversity for histologic subtype or divergent differentiation. However, the efficacy of avelumab against SUC remains unclear. Therefore, the effect of the treatment as well as the survival results of avelumab monotherapy were evaluated as a first-line therapeutic maintenance in patients with advanced SUC.

Methods: A retrospective analysis was conducted on consecutive patients from the Uro-Oncology Group in Kyushu study population with advanced lower and upper urinary tract cancer who underwent avelumab maintenance therapy without progression after first-line platinum-based chemotherapy. Patients with pure urothelial carcinoma (PUC) and SUC were comparatively analyzed based on objective response rate (ORR), disease control rate, progression-free survival (PFS), and overall survival (OS).

Results: Out of 49 recorded patients, 38 and 11 had PUC and SUC, respectively. The most common subtype element was glandular differentiation (n=5), followed by squamous differentiation (n=3), micropapillary (n=1), and plasmacytoid subtypes (n=1). The SUC and PUC groups had comparable ORR (0% vs. 2.6%, P>0.99) and disease control rates (54.5% vs. 44.7%, P=0.73). These patient groups also showed no significant difference in PFS (median 3.9 vs. 3.1 months, P=0.33) or OS (median 16.7 vs. 22.1 months, P=0.47).

Conclusions: The response of SUC and PUC to avelumab was comparable in patients with advanced lower and upper urinary tract cancer, indicating that avelumab maintenance therapy is also effective for SUC.

Keywords: Histologic subtype; avelumab; divergent differentiation; immune checkpoint inhibitors (ICIs); urothelial carcinoma (UC).

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://tau.amegroups.com/article/view/10.21037/tau-24-53/coif). The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Waterfall plot of best percentage change from baseline in patients with PUC and SUC receiving avelumab maintenance therapy. PUC, pure urothelial carcinoma; SUC, subtype of urothelial carcinoma.
Figure 2
Figure 2
Kaplan-Meier curves for the overall survival after the initiation of avelumab maintenance therapy in patients with advanced urothelial carcinoma according to the best response. PD, progressive disease; CR, complete response; PR, partial response; SD, stable disease; NE, could not be evaluated.
Figure 3
Figure 3
Kaplan-Meier curves for the (A) progression-free survival and (B) overall survival after the initiation of avelumab maintenance therapy in patients with PUC and SUC. PUC, pure urothelial carcinoma; SUC, subtype of urothelial carcinoma.
See this image and copyright information in PMC

References

    1. von der Maase H, Sengelov L, Roberts JT, et al. Long-term survival results of a randomized trial comparing gemcitabine plus cisplatin, with methotrexate, vinblastine, doxorubicin, plus cisplatin in patients with bladder cancer. J Clin Oncol 2005;23:4602-8. 10.1200/JCO.2005.07.757 - DOI - PubMed
    1. Dogliotti L, Cartenì G, Siena S, et al. Gemcitabine plus cisplatin versus gemcitabine plus carboplatin as first-line chemotherapy in advanced transitional cell carcinoma of the urothelium: results of a randomized phase 2 trial. Eur Urol 2007;52:134-41. 10.1016/j.eururo.2006.12.029 - DOI - PubMed
    1. Lopez-Beltran A, Cimadamore A, Blanca A, et al. Immune Checkpoint Inhibitors for the Treatment of Bladder Cancer. Cancers (Basel) 2021;13:131. 10.3390/cancers13010131 - DOI - PMC - PubMed
    1. Bellmunt J, de Wit R, Vaughn DJ, et al. Pembrolizumab as Second-Line Therapy for Advanced Urothelial Carcinoma. N Engl J Med 2017;376:1015-26. 10.1056/NEJMoa1613683 - DOI - PMC - PubMed
    1. Powles T, Park SH, Voog E, et al. Avelumab Maintenance Therapy for Advanced or Metastatic Urothelial Carcinoma. N Engl J Med 2020;383:1218-30. 10.1056/NEJMoa2002788 - DOI - PubMed

LinkOut - more resources