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ASCO GU 2024: Long-Term Survivorship With Adjuvant Nivolumab in Urothelial Carcinoma

By: Julia Fiederlein Cipriano, MS
Posted: Friday, February 9, 2024

According to Daniel M. Geynisman, MD, of Fox Chase Cancer Center, Philadelphia, and colleagues, compared with radical resection alone, adjuvant nivolumab is associated with an increased cure rate in high-risk patients with muscle-invasive urothelial carcinoma. The results of the disease-free survival analyses of the phase III CheckMate 274 trial, which were presented during the 2024 American Society of Clinical Oncology (ASCO) Genitourinary (GU) Cancers Symposium (Abstract 528), also demonstrated such benefit for those with a tumor PD-L1 expression level of at least 1%.

“When physicians are talking to patients about whether or not to treat their urothelial carcinoma with adjuvant nivolumab, this is another piece of evidence to support doing so,” Dr. Geynisman commented in an institutional press release. “Although we don’t have mature overall survival data from the trial, the model seems to support an overall survival benefit associated with adjuvant nivolumab.”

The investigators applied mixture cure models to disease-free survival data from patients who underwent radical resection and subsequent treatment with either nivolumab (n = 353; PD-L1 ≥ 1%: 39.7%) or placebo (n = 356; PD-L1 ≥ 1%: 39.9%). Selected models estimated that nearly all patients who were deemed to be at risk for both disease recurrence and all-cause mortality would experience such relapse within 5 years.

The estimated cure fraction in the intention-to-treat (ITT) population ranged from 43.1% to 45.1% with nivolumab and 36.4% to 37.0% with placebo. In patients with higher expression levels of PD-L1, the range was 59.1% to 61.0% with nivolumab and 35.9% to 36.9% with placebo. The projected mean ranges of 10-year disease-free survival in the ITT and elevated PD-L1 populations were 4.4 to 4.5 and 5.5 to 5.7 years with nivolumab and 3.6 (for both) and 3.5 to 3.6 years with placebo, respectively.

Disclosure: For full disclosures of the study authors, visit coi.asco.org.


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