Bone metastases in bladder cancer predict worse outcomes
Click Here to Manage Email Alerts
CHICAGO — Patients with bone metastases due to urothelial carcinoma had worse outcomes than those without bone metastasis, regardless of treatment or PD-L1 expression, according to a poster presentation at ASCO Annual Meeting.
However, median overall survival was better in patients with high PD-L1 expression treated with durvalumab monotherapy or durvalumab plus tremelimumab in patients with and without bone metastases.
“Bone metastases are associated with significant morbidity and mortality in metastatic urothelial carcinoma. Despite this, the independent impact of bone metastases on clinical outcomes is not well understood,” Carlos Stecca, MD, from the division of medical oncology and hematology at Princess Margaret Cancer Centre, Toronto, said in the presentation. “This is especially true in the current era of immune checkpoint inhibitors, and it is unknown whether the same level of response to oncology regimens can be achieved in patients with and without bone metastases.”
In a post hoc analysis of the DANUBE phase 3 trial, Stecca and colleagues evaluated outcomes related to bone metastases and PD-L1 expression in patients with bladder cancer treated with durvalumab monotherapy, durvalumab plus tremelimumab, or standard-of-care chemotherapy. Researchers randomized patients with bone metastases (n = 266) and those without (n = 766) to receive durvalumab alone (n = 97 with metastases; n = 249 without), a combination of durvalumab and tremelimumab (n = 80 with metastases; n = 262 without) and chemotherapy (n = 89 with metastases; n = 255 without).
Among all patients with bone metastases, median OS was lower than in those without (HR = 1.67; 95% CI, 1.43-1.92), as was progression-free survival (HR = 1.52; 95% CI, 1.3-1.75).
Whereas patients with PD-L1-high expression had better median OS when treated with with durvalumab or durvalumab plus tremelimumab, there was no difference in median OS based on PD-L1 expression in patients with or without bone metastasis treated with standard-of-care chemotherapy, Stecca said in the presentation.
“This data reinforces evidence supporting the negative prognostic impact of bone metastases in metastatic urothelial carcinoma, and they present a role for PD-L1 expression in predicting benefit for patients when treated with immune checkpoint inhibitors,” Stecca said.
For more information:
Carlos Stecca, MD, can be reached at carlos.stecca@outlook.com.
Collapse
Stecca C, et al. Poster #4564. Presented at: ASCO Annual Meeting; June 3-7, 2022; Chicago.
Click Here to Manage Email Alerts