{"title":"针对局部晚期或转移性尿路上皮癌，在维持阿维单抗或派姆单抗后再用铂基化疗或强制使用维多汀。","authors":"Nobutaka Nishimura, Makito Miyake, Norimi Takamatsu, Kosuke Mieda, Kuniaki Inoue, Akira Tachibana, Keichi Sakamoto, Mikiko Onishi, Fumisato Maesaka, Takanosuke Yoshikawa, Mitsuru Tomizawa, Takuto Shimizu, Kenta Onishi, Shunta Hori, Yosuke Morizawa, Daisuke Gotoh, Yasushi Nakai, Nobumichi Tanaka, Kiyohide Fujimoto","doi":"10.1177/23523735251317423","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>In current clinical practice, the use of switch maintenance avelumab is recommended for patients with locally advanced and metastatic urothelial carcinoma who experience favorable responses to first-line chemotherapy.</p><p><strong>Objective: </strong>We aimed to evaluate the potential advantages of platinum-based chemotherapy (Pl-CT) rechallenge after maintenance avelumab.</p><p><strong>Methods: </strong>A retrospective analysis involving 383 patients treated with first-line Pl-CT between 2015 and 2023 was conducted. Subsequent treatment strategies included Pl-CT or enfortumab vedotin (EV) following maintenance avelumab or pembrolizumab, and their benefit was evaluated.</p><p><strong>Results: </strong>Pl-CT rechallenge following maintenance avelumab did not show significant benefits, demonstrating lower response rates and shorter progression-free survival compared to EV. Conversely, both Pl-CT and EV following pembrolizumab showed similar efficacy.</p><p><strong>Conclusions: </strong>These findings suggest that in the current clinical landscape, EV might be a more preferable option than Pl-CT rechallenge subsequent to avelumab maintenance therapy, thereby influencing treatment decisions for metastatic urothelial carcinoma.</p>","PeriodicalId":54217,"journal":{"name":"Bladder Cancer","volume":"11 1","pages":"23523735251317423"},"PeriodicalIF":1.2000,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11926830/pdf/","citationCount":"0","resultStr":"{\"title\":\"Platinum-based chemotherapy rechallenge or enfortumab vedotin after maintenance avelumab or pembrolizumab for locally advanced or metastatic urothelial carcinoma.\",\"authors\":\"Nobutaka Nishimura, Makito Miyake, Norimi Takamatsu, Kosuke Mieda, Kuniaki Inoue, Akira Tachibana, Keichi Sakamoto, Mikiko Onishi, Fumisato Maesaka, Takanosuke Yoshikawa, Mitsuru Tomizawa, Takuto Shimizu, Kenta Onishi, Shunta Hori, Yosuke Morizawa, Daisuke Gotoh, Yasushi Nakai, Nobumichi Tanaka, Kiyohide Fujimoto\",\"doi\":\"10.1177/23523735251317423\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>In current clinical practice, the use of switch maintenance avelumab is recommended for patients with locally advanced and metastatic urothelial carcinoma who experience favorable responses to first-line chemotherapy.</p><p><strong>Objective: </strong>We aimed to evaluate the potential advantages of platinum-based chemotherapy (Pl-CT) rechallenge after maintenance avelumab.</p><p><strong>Methods: </strong>A retrospective analysis involving 383 patients treated with first-line Pl-CT between 2015 and 2023 was conducted. Subsequent treatment strategies included Pl-CT or enfortumab vedotin (EV) following maintenance avelumab or pembrolizumab, and their benefit was evaluated.</p><p><strong>Results: </strong>Pl-CT rechallenge following maintenance avelumab did not show significant benefits, demonstrating lower response rates and shorter progression-free survival compared to EV. Conversely, both Pl-CT and EV following pembrolizumab showed similar efficacy.</p><p><strong>Conclusions: </strong>These findings suggest that in the current clinical landscape, EV might be a more preferable option than Pl-CT rechallenge subsequent to avelumab maintenance therapy, thereby influencing treatment decisions for metastatic urothelial carcinoma.</p>\",\"PeriodicalId\":54217,\"journal\":{\"name\":\"Bladder Cancer\",\"volume\":\"11 1\",\"pages\":\"23523735251317423\"},\"PeriodicalIF\":1.2000,\"publicationDate\":\"2025-03-20\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11926830/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Bladder Cancer\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/23523735251317423\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q4\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Bladder Cancer","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/23523735251317423","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"ONCOLOGY","Score":null,"Total":0}
Platinum-based chemotherapy rechallenge or enfortumab vedotin after maintenance avelumab or pembrolizumab for locally advanced or metastatic urothelial carcinoma.
Background: In current clinical practice, the use of switch maintenance avelumab is recommended for patients with locally advanced and metastatic urothelial carcinoma who experience favorable responses to first-line chemotherapy.
Objective: We aimed to evaluate the potential advantages of platinum-based chemotherapy (Pl-CT) rechallenge after maintenance avelumab.
Methods: A retrospective analysis involving 383 patients treated with first-line Pl-CT between 2015 and 2023 was conducted. Subsequent treatment strategies included Pl-CT or enfortumab vedotin (EV) following maintenance avelumab or pembrolizumab, and their benefit was evaluated.
Results: Pl-CT rechallenge following maintenance avelumab did not show significant benefits, demonstrating lower response rates and shorter progression-free survival compared to EV. Conversely, both Pl-CT and EV following pembrolizumab showed similar efficacy.
Conclusions: These findings suggest that in the current clinical landscape, EV might be a more preferable option than Pl-CT rechallenge subsequent to avelumab maintenance therapy, thereby influencing treatment decisions for metastatic urothelial carcinoma.
期刊介绍：
Bladder Cancer is an international multidisciplinary journal to facilitate progress in understanding the epidemiology/etiology, genetics, molecular correlates, pathogenesis, pharmacology, ethics, patient advocacy and survivorship, diagnosis and treatment of tumors of the bladder and upper urinary tract. The journal publishes research reports, reviews, short communications, and letters-to-the-editor. The journal is dedicated to providing an open forum for original research in basic science, translational research and clinical medicine that expedites our fundamental understanding and improves treatment of tumors of the bladder and upper urinary tract.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
