Cecilia Brown

GU Oncology Now

Most patients with advanced urothelial carcinoma who had disease control after 4 cycles of first-line chemotherapy did not have a &gt;10% reduction in tumor size when they received an additional 2 cycles of chemotherapy, according to a recent study.Akihiro Hamada, MD, of the Kyoto University Graduate School of Medicine, and colleagues conducted the retrospective study to &ldquo;investigate the correlation between tumor size changes during the initial 4 cycles of first-line chemotherapy and tumor shrinkage following 2 additional cycles of chemotherapy in patients with advanced urothelial carcinoma who experienced disease control after initial chemotherapy.&rdquo; They published the study&rsquo;s results in Urologic Oncology: Seminars and Original Investigations.Dr. Hamada and colleagues reviewed data from 128 patients with advanced urothelial carcinoma who received first-line chemotherapy. They analyzed 51 patients who had disease control, defined as stable disease or better, at the end of the fourth chemotherapy cycle. Most of those 51 patients (92.1%) underwent 1 to 2 additional chemotherapy cycles, while the remaining 7.9% underwent observation.The researchers defined 4 categories to describe the tumor size changes in patients who received 1 to 2 more additional chemotherapy cycles. The categories were &ldquo;no shrinkage,&rdquo; defined as tumor growth; &ldquo;minor shrinkage,&rdquo; defined as no tumor growth or a &le;10% reduction in tumor size; and &ldquo;shrinkage,&rdquo; defined as a &gt;10% reduction in tumor size.Dr. Hamada and colleagues categorized the change in tumor size as &ldquo;no shrinkage&rdquo; in 44.7% of patients, &ldquo;minor shrinkage&rdquo; in 38.3%, and &ldquo;shrinkage&rdquo; in 17%.The rate of tumor size change between cycles 3 and 4 was significantly associated with the trend of tumor shrinkage (P=.009) and the &ldquo;likelihood of beneficial tumor shrinkage&rdquo; after additional chemotherapy (P=.02), according to the researchers.&ldquo;However, the change in tumor size between cycles 1 and 2, cycles 1 and 4, or cycles 3 and 4 was not satisfactorily predictive of further tumor shrinkage because of substantial overlaps of the tumor size changes,&rdquo; Dr. Hamada and colleagues wrote.The results of the research may inform treatment approaches to advanced urothelial carcinoma, according to the researchers.&ldquo;Only a small subset of patients would have substantial tumor shrinkage by additional cycles after successful induction of 4-cycle chemotherapy. Tumor size dynamics during the initial 4 cycles of chemotherapy displayed limited ability to predict the subset of patients with further tumor shrinkage after additional chemotherapy,&rdquo; Dr. Hamada and colleagues concluded. &ldquo;Therefore, it might be better to consider switch maintenance immunotherapy for patients who experience disease control after the fourth cycle of first-line chemotherapy.&rdquo;Reference<a href="https://doi.org/10.1016/j.urolonc.2022.07.008" target="_blank" rel="noopener">Limited Predictive Impact of Tumor Size Dynamics on Further Tumor Shrinkage After 4 Cycles of First-Line Chemotherapy in Patients With Advanced Urothelial Carcinoma</a>

Extra Chemo Cycles Unlikely to Shrink Tumors in Advanced Urothelial Carcinoma

Advanced Urothelial Carcinoma

An extra 2 cycles of chemotherapy in patients with advanced urothelial carcinoma did not lead to tumor size reduction in most cases.

Extra Chemo Cycles Unlikely to Shrink Tumors in AUC

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