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Lookup NU author(s): Dr Pasquale RescignoORCiD
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
© 2025 by American Society of Clinical Oncology.PURPOSE Our investigation assessed the impact of geographical disparities in the treatment of patients with advanced urothelial cancer (aUC) included in the international, real-world ARON-2 trial. PATIENTS AND The study population comprised 1,137 patients with aUC treated with pemMETHODS brolizumab for relapsed or progressive disease after platinum-based chemotherapy (PBC) at 63 institutions in 19 countries. Patients were divided into three geographical areas: Europe (area 1: 791 patients), the United States (area 2: 156 patients), and Asia (area 3: 190 patients). Clinicopathologic and treatment data were extracted from medical records. The primary end points were to identify differences in patient and treatment characteristics and to assess overall survival (OS) and progression-free survival (PFS) between the three areas. RESULTS There were differences in patient characteristics: more patients age 70 years and older in area 1; more patients with BMI ≥25 kg/m2, squamous histotype, and T1 neoplasia at diagnosis in area 2; and more pure urothelial carcinoma in area 3. There were differences in treatment characteristics: Bacillus Calmette-Guérin instillations and primary tumor surgery were more common in area 1; neoadjuvant and adjuvant PBC, third-line therapies, and specifically enfortumab vedotin (EV) were less common in area 1. Median OS (mOS) from pembrolizumab initiation was 13.0 months in area 1, 29.1 months in area 2 and 13.2 months in area 3 (P < .001), and median PFS was 4.8 months, 5.2 months, and 3.8 months, respectively (P 5 .002). In patients receiving EV after progression to PBC and pembrolizumab, mOS was 44.1 months in area 1, 31.7 months in area 2, and 23.8 months in area 3 (P 5 .267). CONCLUSION Real-world data suggest that facilitating and extending access to targeted therapies for patients with aUC in different geographical areas worldwide may lead to a consistent and widespread survival increase.
Author(s): Rizzo M, Soares A, Gupta S, Calabro F, Takeshita H, Bourlon MT, Park SH, Giannatempo P, Myint ZW, Buttner T, Grande E, Fiala O, Santini D, Bamias A, Zakopoulou R, Buti S, Kanesvaran R, Rescigno P, Molina-Cerrillo J, Epstein I, Marques Monteiro FSM, Massari F, Porta C, Bellmunt J, Santoni M
Publication type: Article
Publication status: Published
Journal: JCO Global Oncology
Year: 2025
Volume: 11
Print publication date: 01/07/2025
Online publication date: 08/07/2025
Acceptance date: 14/04/2025
Date deposited: 28/07/2025
ISSN (electronic): 2687-8941
Publisher: Lippincott Williams and Wilkins
URL: https://doi.org/10.1200/GO-24-00564
DOI: 10.1200/GO-24-00564
Data Access Statement: The data sets generated and/or analyzed during the current study are not publicly available because of patient data security but are available from the last author on reasonable request.
PubMed id: 40627820
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