Tislelizumab, an immune checkpoint inhibitor, combined with gemcitabine plus cisplatin chemotherapy as first-line adjuvant treatment for locally advanced or metastatic bladder cancer can provide patients with “encouraging antitumor activity,” investigators concluded based on a small retrospective pilot study.
The study included 31 patients, of whom 14 received tislelizumab plus gemcitabine/cisplatin and 17 received only gemcitabine/cisplatin. All patients underwent bladder cytoreductive surgery and were treated for 4 cycles of 21 days each until disease progression or intolerable treatment-related adverse events (TRAEs). The median survival follow-up duration was 54.3 weeks and 52.1 weeks for the tislelizumab arm and gemcitabine/cisplatin arm, respectively.
At a cutoff date of March 25, 2022, the median progression-free survival was 36 weeks in the tislelizumab arm and 29 weeks in the gemcitabine/cisplatin group, Xiaoyong Zeng, MD, of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology in Wuhan, China, and colleagues reported in BMC Urology. The tislelizumab group had a significant 85% decreased risk for disease progression compared with gemcitabine/cisplatin arm.
The median overall survival was 48 weeks for the gemcitabine/cisplatin group and not yet mature for the tislelizumab arm, which experienced a significant 74% decreased risk of death.
Further, the tislelizumab arm had an improved disease control rate compared with the gemcitabine/cisplatin group (71.4% vs 65%), as well as an improved clinical benefit rate (64.3% vs 52.9%).
The tislelizumab group had more grade 3 or higher TRAEs than the gemcitabine/cisplatin arm, but the difference was not statistically significant (35.7% vs 23.5%). “The results showed that tislelizumab in combination with chemotherapy was generally tolerated and manageable in any grade TRAEs.”
“To our knowledge, this was the first retrospective report of [gemcitabine/cisplatin] chemotherapy as a single agent or in combination with tislelizumab in patients with locally advanced or metastatic bladder cancer as the first line therapy,” the authors wrote.
Ren X, Tian Y, Wang Z, et al. Tislelizumab in combination with gemcitabine plus cisplatin chemotherapy as first-line adjuvant treatment for locally advanced or metastatic bladder cancer: a retrospective study. BMC Urol. Published online August 20, 2022. doi:10.1186/s12894-022-01083-8