Resumen de 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
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.
