Efficacy of Vinflunine for Patients with Metastatic Urothelial Cancer after Immune Checkpoint Inhibitor Pretreatment—A Retrospective Multicenter Analysis

Cancers

Danijel Sikic¹  Maximilian Burger²  Marco J. Schnabel²  Johannes Breyer²  Mara Münker³  Florian Roghmann³  Thomas Büttner⁴  Manuel Ritter⁴  Felix Riedel⁵  Felix Wezel⁵  Friedemann Zengerling⁵  Christian Bolenz⁵  Kiriaki Hiller⁶ 

[1] Department of Urology and Pediatric Urology, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nuremberg, 91054 Erlangen, Germany;Department of Urology, Caritas Hospital St. Josef, University of Regensburg, 93053 Regensburg, Germany;Department of Urology, Marien Hospital, Ruhr-University Bochum, 44625 Herne, Germany;Department of Urology, University Hospital Bonn (UKB), 53127 Bonn, Germany;Department of Urology, University Hospital Ulm, 89081 Ulm, Germany;National Center for Tumor Diseases (NCT) Heidelberg, 69120 Heidelberg, Germany;

关键词: metastatic urothelial carcinoma;    bladder cancer;    immune checkpoint inhibition;    immunotherapy;    vinflunine;    chemotherapy;   

DOI  :  10.3390/cancers14122850

来源: DOAJ

【 摘 要 】

Background: Immune checkpoint inhibitors (ICI) are standard of care in patients with metastatic urothelial carcinoma (mUC) ineligible for cisplatin, and as second-line therapy after platinum-based chemotherapy. To date, few data exist about the efficacy of the former second-line chemotherapeutic agent vinflunine after the failure of sequential platinum-based chemotherapy and ICI treatment. The aim of this analysis was to examine the efficacy of vinflunine in a post-ICI third- or later-line setting. Methods: In this retrospective German multicenter study, data of mUC patients treated with vinflunine were reviewed in six centers between February 2010 and December 2021. All of the 105 included patients had radiologic progression after first-line platinum-based chemotherapy. The objective was to describe the efficacy of vinflunine in terms of overall response rate (ORR), clinical benefit rate (CBR), overall survival (OS), and progression-free survival (PFS) for post-ICI and ICI-naïve patients, respectively. Results: In our cohort, 61 patients (58.1%) had preceding immunotherapy before vinflunine administration, and 44 patients (41.9%) were ICI-naïve. Patients with ICI pretreatment showed an ORR of 22.4% compared to 15.6% within ICI-naïve patients (p = 0.451), and CBR was 51.0% vs. 25.0% (p = 0.020), respectively. Post-ICI patients showed longer OS (8.78 vs. 5.72 months; p = 0.467) and longer PFS (3.09 vs. 2.14 months; p = 0.105). Conclusion: This analysis supports the sequential use of vinflunine in post-ICI patients since the vinca-alkaloid retains a measurable clinical activity in these heavily pretreated patients. The therapeutic benefit may be higher than demonstrated in previous studies.

【 授权许可】

Unknown