For this study, data from 15 centers was collected, totaling 1,544 patients treated between 2000 and 2015. Criteria for patient selection included: (i) UTUC diagnosis, and (ii) pT2-4N0/x and/or pN+ stage undergoing radical nephroureterectomy. The standardized differences (SD) approach was used to compare subgroup characteristics. Overall survival (OS) was the primary endpoint. The adopted propensity scores techniques included 1:1 propensity score matching and inverse probability of treatment weighting (IPTW). Additionally, the IPTW analysis was performed with the inclusion of the covariates, i.e. with doubly robust estimation (DREP). Finally, six-month landmark analysis was also performed.
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In conclusion, adjuvant chemotherapy does not improve OS compared to observation in pT2-4 and/or pN+ UTUC. These findings contribute to the uncertainties regarding adjuvant chemotherapy in UTUC and further support the need for dedicated prospective trials in UTUC, more potent new therapies, standardized lymphadenectomy templates, and enhanced patient selection criteria.
Speaker: Andrea Necchi, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
Co-Authors: S. Lo Vullo (Milan, Italy) L. Mariani (Milan, Italy) M. Moschini (Luzern, Switzerland) K. Hendricksen (Amsterdam, Netherlands) M. Rink (Eppendorf, Germany) R. Sosnowski (Otwock, Poland) J. Dobruch (Warsaw, Poland) J. D. Raman (Hershey, United States of America) C. G. Wood (Houston, United States of America) V. Margulis (Dallas, United States of America) M. Rouprêt (Paris, France) A. Briganti (Milano, Italy) F. Montorsi (Milan, Italy) E. Xylinas (Paris, France) S. F. Shariat (Vienna, Austria)
Written By: Zachary Klaassen, MD, Urologic Oncology Fellow, University of Toronto, Princess Margaret Cancer Centre, Twitter: @zklaassen_md at the European Society for Medical Oncology Annual Congress - September 8 - 12, 2017 - Madrid, Spain
Heery CR, O’Sullivan-Coyne G, Madan RA, et al. Avelumab for metastatic or locally advanced previously treated solid tumours (JAVELIN Solid Tumor): A phase 1a, multicohort, dose-escalation trial. Lancet Oncol 2017;18(5):587-598.