Bladder‑sparing treatment using tislelizumab combined with gemcitabine/cisplatin in selected patients with muscle‑invasive bladder cancer: a real‑world study

Cheng Luo; Shuhang Luo; Wumier Wusimanjiang; Zongren Wang; Junxing Chen; Bin Huang; Ping Liu; Nan Deng; Kaihui Wu; Bin Wang; Xuejin Zhu; Dan Yuan; Hao Lin; Abai Xu; Peng Xu

Ayuda

Bladder‑sparing treatment using tislelizumab combined with gemcitabine/cisplatin in selected patients with muscle‑invasive bladder cancer: a real‑world study

Cheng Luo ^[1] ; Shuhang Luo ^[1] ; Wumier Wusimanjiang ^[1] ; Zongren Wang ^[1] ; Junxing Chen ^[1] ; Bin Huang ^[1] ; Ping Liu ^[4] ; Nan Deng ^[4] ; Kaihui Wu ^[4] ; Bin Wang ^[5] ; Xuejin Zhu ^[5] ; Dan Yuan ^[6] ; Hao Lin ^[2] ; Abai Xu ^[3] ; Peng Xu ^[3]
1. [1] Sun Yat-sen University
  
  Sun Yat-sen University
  
  China
2. [2] Shantou University Medical College
  
  Shantou University Medical College
  
  China
3. [3] Southern Medical University
  
  Southern Medical University
  
  China
4. [4] Department of Urology, The Third Afliated Hospital of Guangzhou Medical University, Guangzhou, China
5. [5] Department of Urology, Afliated Cancer Hospital and Institute of Guangzhou Medical University, Guangzhou, China
6. [6] Department of Urology, Jiangmen Central Hospital, Jiangmen, China
Mostrar afiliaciones +
Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 26, Nº. 7, 2024, págs. 1759-1767
Idioma: inglés
Texto completo no disponible (Saber más ...)
Resumen
- Purpose To retrospectively evaluate the tislelizumab-based chemoimmunotherapy combined with gemcitabine/cisplatin for bladder-sparing in patients with muscle-invasive bladder cancer (MIBC).
  
  Methods Forty-fve patients who received bladder-sparing treatment or radical cystectomy (RC) for MIBC (cT2-T4a, NxM0) were retrospectively enrolled. All patients received maximal transurethral resection of bladder tumor (mTURBT), followed by four cycles of chemo-immunotherapy with tislelizumab (PD-L1 inhibitor), gemcitabine, and cisplatin. Clinical efcacy was evaluated to compare the beneft of bladder-sparing treatment on clinical CR (cCR) and RC for non-cCR patients. The primary outcomes were bladder intact disease-free survival (BIDFS) and overall survival (OS), and the secondary outcomes were adverse efects. The PD-L1 status and molecular subtypes of tumors were analyzed.
  
  Results The overall survival rate was 88.8% (95%CI: 79.6%, 98.0%) at 12 months, 85.7% (95%CI: 74.9%, 96.5%) at 18 months, and 66.6% (95%CI: 45.2%, 88.0%) at 24 months. Twenty-nine patients (64.4%) achieved cCR and their OS rate was 96.6% (95%CI: 89.9%, 100%). Sixteen patients were in the non-cCR group, and their OS rate was 75.0% (95%CI: 53.8%, 96.2%) at 12 months, 65.6% (95%CI: 40.3%, 90.9%) at 18 months, and 52.5% (95%CI: 21.9%, 83.1%) at 24 months. The BIDFS rate for patients who received bladder-sparing treatment was 96.0% (95%CI: 88.4%, 100%) from 12 to 24 months. Four patients (8.8%) were PD-L1 positive and 41 patients (91.2%) were PD-L1 negative.
  
  Conclusions Our retrospective study of patients with MIBC suggests that tislelizumab-based neoadjuvant therapy was a safe and efective bladder-sparing treatment.