Treatments Outcomes in Histological Variants and Non-Urothelial Bladder Cancer: Results of a Multicenter Retrospective Study.

Less than one-third of bladder cancers are non-pure urothelial carcinoma [with variant histological (VH) or non-urothelial carcinoma (non-UC)] for which no treatment guidelines are available. We aim to evaluate the efficacy of systemic treatments in VH or non-UC bladder cancers. Multicenter retrospective analysis of patients treated for advanced or metastatic VH or non-UC bladder cancers. Primary endpoint was overall response rate (ORR) according to treatment line, regimen and histology subtype. Secondary endpoints were progression-free survival (PFS) and overall survival (OS). Between 2005 and 2020, 46 patients from seven centers were included. The median age was 66 years (58.75; 74.75), 65.2% were male and 67.2% presented VH. At first line, the ORR for the entire population was 54.4% and median OS was 21.6 months (95% confidence interval [CI]: 14.2-38.6). The ORR of the 37 patients treated with chemotherapy at first line was 62.2% with median PFS and OS of 7.3 (95% CI: 4.5-8.6) and 21.6 months (95% CI: 14.2-35.7), respectively. Dose dense MVAC and platinum doublet chemotherapy had the highest ORR (71.4% and 65.2%). The 9 patients treated with immunotherapy at first line had an ORR of 22.2%, a median PFS of 3.3 months (95% CI:2.3-NR) and the median OS was not reached (95% CI:13.8-NR). Response to treatment varied depending on the histological sub-types and on the treatment type. Chemotherapy and immunotherapy have shown to be effective in VH or non-UC cancers, a rare histological subtype for which we currently have very little data in the literature.

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Copyright © 2021 Epaillard, Parent, Loriot, Lavaud, Vera-Cea, Martinez-Chanza, Rodriguez-Vida, Dumont, Lozano, Llácer, Ratta, Oudard, Thibault and Auclin.

Déclaration de conflit d'intérêts

YL reports Grant, personal fees and nonfinancial support from Janssen and MSD; personal fees and nonfinancial support from Astellas, Roche, AstraZeneca, BMS and Seattle Genetics; grant and personal fees from Sanofi; personal fees from Clovis, Incyte and Pfizer. PL reports conflict of interest with IPSEN Mundi Pharma JANSSEN Astellas Pfizer Astra Zeneca. AR-V reports serving in an advisory role for MSD, Pfizer, BMS, Astellas, Janssen, Bayer, Clovis and Roche; receiving honoraria or travel expenses from Pfizer, MSD, Astellas, BMS, Janssen, Astra Zeneca, Roche, Bayer, and Sanofi Aventis; and receiving research funding from Takeda, Pfizer, and MSD. NM-C reports support for research travel from Pfizer, Janssen and Ipsen, and consulting fees for BMS, Pfizer, Sanofi and Bayer. CD reports consulting or Advisory Role: Pfizer. Travel, Accommodations, Expenses: Ipsen, Pfizer, MSD. CL reports Speakers’ bureau: Roche. Travel, Accommodations, Expenses: Astellas Pharma, Angelini Pharma. RR reports Consulting/Advisory board: Pfizer, MSD; Travel, Accommodations, Expenses: Pfizer. SO declares honoraria from Sanofi, Astellas, Janssen, Bayer, Pfizer, Novartis, Ipsen, MSD, BMS, and Astra Zeneca. CT declares Board: BMS, Pfizer, Pfizer, Ipsen, MSD, Astellas, Janssen, AstraZeneca, Merck, Sanofi. Travel: Pfizer, Sanofi, AstraZeneca. Funding: AstraZeneca, Sanofi. EA reports Travel expenses: Mundipharma. Lectures and educational activities: Sanofi Genzymes. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.