Patients with Muscle-Invasive Bladder Cancer with Nonluminal Subtype Derive Greatest Benefit from Platinum Based Neoadjuvant Chemotherapy

dc.contributor.authorLotan, Yair
dc.contributor.authorde Jong, Joep J.
dc.contributor.authorLiu, Vinnie Y. T.
dc.contributor.authorBismar, Tarek A.
dc.contributor.authorBoorjian, Stephen A.
dc.contributor.authorHuang, Huei-Chung
dc.contributor.authorDavicioni, Elai
dc.contributor.authorMian, Omar Y.
dc.contributor.authorWright, Jonathan L.
dc.contributor.authorNecchi, Andrea
dc.contributor.authorDall'Era, Marc A.
dc.contributor.authorKaimakliotis, Hristos Z.
dc.contributor.authorBlack, Peter C.
dc.contributor.authorGibb, Ewan A.
dc.contributor.authorBoormans, Joost L.
dc.contributor.departmentUrology, School of Medicineen_US
dc.date.accessioned2023-03-07T18:04:26Z
dc.date.available2023-03-07T18:04:26Z
dc.date.issued2022-03
dc.description.abstractPurpose: Neoadjuvant chemotherapy (NAC) prior to radical cystectomy (RC) in patients with nonmetastatic muscle-invasive bladder cancer (MIBC) confers an absolute survival benefit of 5%–10%. There is evidence that molecular differences between tumors may impact response to therapy, highlighting a need for clinically validated biomarkers to predict response to NAC. Materials and Methods: Four bladder cancer cohorts were included. Inverse probability weighting was used to make baseline characteristics (age, sex and clinical tumor stage) between NAC-treated and untreated groups more comparable. Molecular subtypes were determined using a commercial genomic subtyping classifier. Survival rates were estimated using weighted Kaplan-Meier curves. Cox proportional hazards models were used to evaluate the primary and secondary study end points of overall survival (OS) and cancer-specific survival, respectively. Results: A total of 601 patients with MIBC were included, of whom 247 had been treated with NAC and RC, and 354 underwent RC without NAC. With NAC, the overall net benefit to OS and cancer-specific survival at 3 years was 7% and 5%, respectively. After controlling for clinicopathological variables, nonluminal tumors had greatest benefit from NAC, with 10% greater OS at 3 years (71% vs 61%), while luminal tumors had minimal benefit (63% vs 65%) for NAC vs non-NAC. Conclusions: In patients with MIBC, a commercially available molecular subtyping assay revealed nonluminal tumors received the greatest benefit from NAC, while patients with luminal tumors experienced a minimal survival benefit. A genomic classifier may help identify patients with MIBC who would benefit most from NAC.en_US
dc.eprint.versionFinal published versionen_US
dc.identifier.citationLotan, Y., de, J. J. J., Liu, V. Y. T., Bismar, T. A., Boorjian, S. A., Huang, H.-C., Davicioni, E., Mian, O. Y., Wright, J. L., Necchi, A., Dall, ’Era Marc A., Kaimakliotis, H. Z., Black, P. C., Gibb, E. A., & Boormans, J. L. (2022). Patients with Muscle-Invasive Bladder Cancer with Nonluminal Subtype Derive Greatest Benefit from Platinum Based Neoadjuvant Chemotherapy. Journal of Urology, 207(3), 541–550. https://doi.org/10.1097/JU.0000000000002261en_US
dc.identifier.urihttps://hdl.handle.net/1805/31692
dc.language.isoenen_US
dc.publisherAUAen_US
dc.relation.isversionof10.1097/JU.0000000000002261en_US
dc.relation.journalJournal of Urologyen_US
dc.rightsAttribution-NonCommercial-NoDerivatives 4.0 International*
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/*
dc.sourcePublisheren_US
dc.subjecturinary bladder neoplasmsen_US
dc.subjectneoadjuvant therapyen_US
dc.subjectmolecular typingen_US
dc.titlePatients with Muscle-Invasive Bladder Cancer with Nonluminal Subtype Derive Greatest Benefit from Platinum Based Neoadjuvant Chemotherapyen_US
dc.typeArticleen_US
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