Patients with metastatic urothelial carcinoma (mUC) treated with both chemotherapy and local radiation therapy (RT) have better overall survival compared with those who receive chemotherapy alone, new data presented at the virtual 2021 Genitourinary Cancer Symposium suggest.
The data are from a study of 4459 patients with newly diagnosed mUC identified using the National Cancer Database. Of these, 337 received chemotherapy plus RT and 4122 received chemotherapy alone. The median follow-up was 10.7 months.
The median overall survival (OS) was 13.8 months for the RT group compared with 8.4 months for the chemotherapy-only group, Benjamin W. Fischer-Valuck, MD, of Emory University School of Medicine in Atlanta, Georgia, and colleagues reported. On multivariable analysis, RT was significantly associated with a 30% reduced risk for death.
Increasing age, Charlson Comorbidity Index score, and clinical T stage were associated with worse OS.
In a subgroup analysis of patients with no comorbidities, the median OS was significantly greater for the combination-treatment arm than the chemotherapy-only arm (14.4 vs 11.1 months).
On propensity matched analysis (337 in the chemotherapy plus RT arm and 337 in the chemotherapy-only arm), the combination treatment was significantly associated with improved OS (13.8 vs 8.5 months). On multivariable analysis, the combination treatment was significantly associated with a 41% decreased risk for death compared with chemotherapy alone.
Landmark analyses for patients living 6 months or more and 12 months or more found significantly improved OS among patients in the combination arm than in the monotherapy arm (median 16.3 vs 13.6 months and 22.2 vs 19.1 months, respectively).
Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.
Fischer-Valuck BW, Patel SA, Gay HA, et al. Association of survival and local radiotherapy to the bladder versus chemotherapy alone for patients with metastatic urothelial carcinoma (mUC). Presented at the virtual 2021 Genitourinary Cancers Symposium, February 11 to 13. Abstract 413.