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Neoadjuvant immunotherapy, chemotherapy, and combination therapy in muscle-invasive bladder cancer: A multi-center real-world retrospective study

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单位： [1]Department of Urology, Xiangya Hospital, Central South University, Changsha, China [2]National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China [3]Department of Urology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China [4]Department of Urology, Tongji Hospital, Huazhong University of Science & Technology, Wuhan, China [5]Department of Urology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China [6]Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, China [7]Department of Urology, Shengjing Hospital, China Medical University, Shenyang, China [8]Department of Urology, Hunan Provincial People’s Hospital, the First Affiliated Hospital of Hunan Normal University, Changsha, China [9]Department of Urology, Zhangjiajie People’s Hospital, Zhangjiajie, China [10]Department of Urology, the First People’s Hospital of Chenzhou, Chenzhou, China [11]Department of Urology, the Central Hospital of Yongzhou, Yongzhou, China [12]Department of Urology, the First People’s Hospital of Xiangtan City, Xiangtan, China [13]Department of Urology, Huarong People’s Hospital, Yueyang, China [14]Department of Urology, Xiangyang Central Hospital, Xiangyang, China [15]Department of Urology, Hunan Cancer Hospital, Changsha, China [16]Department of Pathology, Xiangya Hospital, Central South University, Changsha, China [17]Department of Urology, the Affiliated Hospital of Xiangnan University, Xiangnan University, Chenzhou, China

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To parallelly compare the efficacy of neoadjuvant immunotherapy (tislelizumab), neoadjuvant chemotherapy (gemcitabine and cisplatin), and neoadjuvant combination therapy (tislelizumab + GC) in patients with muscle-invasive bladder cancer (MIBC) and explore the efficacy predictors, we perform a multi-center, real-world cohort study that enrolls 253 patients treated with neoadjuvant treatments (combination therapy: 98, chemotherapy: 107, and immunotherapy: 48) from 15 tertiary hospitals. We demonstrate that neoadjuvant combination therapy achieves the highest complete response rate and pathological downstaging rate compared with neoadjuvant immunotherapy or chemotherapy. We develop and validate an efficacy prediction model consisting of pretreatment clinical characteristics, which can pinpoint candidates to receive neoadjuvant combination therapy. We also preliminarily reveal that patients who achieve pathological complete response after neoadjuvant treatments plus maximal transurethral resection of the bladder tumor may be safe to receive bladder preservation therapy. Overall, this study highlights the benefit of neoadjuvant combination therapy based on tislelizumab for MIBC.Copyright © 2022 The Author(s). Published by Elsevier Inc. All rights reserved.

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第一作者单位： [1]Department of Urology, Xiangya Hospital, Central South University, Changsha, China [2]National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China

通讯作者：

通讯机构： [1]Department of Urology, Xiangya Hospital, Central South University, Changsha, China [2]National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China

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