Chemotherapy is superior to checkpoint inhibitors after radical surgery for urothelial carcinoma: a systematic review and network meta-analysis of oncologic and toxicity outcomes

Ekaterina Laukhtina; Reza Sari Motlagh; Keiichiro Mori; Satoshi Katayama; Pawel Rajwa; Takafumi Yanagisawa; Fahad Quhal; Hadi Mostafaei; Nico C. Grossmann; Frederik König; Abdulmajeed Aydh; Benjamin Pradere; Irene Resch; Axel S. Merseburger; Dmitry Enikeev; Shahrokh F. Shariat

doi:10.1016/j.critrevonc.2021.103570

Chemotherapy is superior to checkpoint inhibitors after radical surgery for urothelial carcinoma: a systematic review and network meta-analysis of oncologic and toxicity outcomes

Ekaterina Laukhtina, Reza Sari Motlagh, Keiichiro Mori, Satoshi Katayama, Pawel Rajwa, Takafumi Yanagisawa, Fahad Quhal, Hadi Mostafaei, Nico C. Grossmann, Frederik König, Abdulmajeed Aydh, Benjamin Pradere, Irene Resch, Axel S. Merseburger, Dmitry Enikeev, Shahrokh F. Shariat^*

^*Corresponding author for this work

15 Citations (Scopus)

Abstract

Objective: To determine the oncologic and toxicity outcomes of adjuvant immunotherapy with immune checkpoint inhibitors (ICIs) compared to adjuvant chemotherapy in patients treated with radical surgery for urothelial carcinoma (UC). Methods: We used the Bayesian approach in the network meta-analysis of different therapy regimens compared to observation or placebo. Results: Nine studies comprised of 2,444 patients met the eligibility criteria. In bladder UC, chemotherapy, atezolizumab, and nivolumab did not improve disease progression compared to observation/placebo. In upper tract UC (UTUC), chemotherapy was significantly associated with a lower likelihood of disease progression compared to observation/placebo, while atezolizumab and nivolumab were not. Based on the analysis of the treatment ranking, adjuvant chemotherapy appeared as the best treatment approach in both bladder UC and UTUC. The risk of adverse events with ICIs was comparable to that of observation/placebo. Conclusion: Our analysis suggests a superior oncologic benefit to adjuvant chemotherapy over ICIs in patients treated with radical surgery for both bladder UC and UTUC.

Original language	English
Article number	103570
Journal	Critical Reviews in Oncology/Hematology
Volume	169
Pages (from-to)	103570
ISSN	1040-8428
DOIs	https://doi.org/10.1016/j.critrevonc.2021.103570
Publication status	Published - 01.2022

Funding

Pawel Rajwa is supported by the EUSP Scholarship of the European Association of Urology (EAU). Nico C. Grossmann is supported by the Zurich Cancer League.

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Research Areas and Centers

Research Area: Luebeck Integrated Oncology Network (LION)

DFG Research Classification Scheme

2.22-14 Hematology, Oncology
2.22-23 Reproductive Medicine, Urology
2.21-05 Immunology

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10.1016/j.critrevonc.2021.103570

Cite this

Laukhtina, E., Sari Motlagh, R., Mori, K., Katayama, S., Rajwa, P., Yanagisawa, T., Quhal, F., Mostafaei, H., Grossmann, N. C., König, F., Aydh, A., Pradere, B., Resch, I., Merseburger, A. S., Enikeev, D., & Shariat, S. F. (2022). Chemotherapy is superior to checkpoint inhibitors after radical surgery for urothelial carcinoma: a systematic review and network meta-analysis of oncologic and toxicity outcomes. Critical Reviews in Oncology/Hematology, 169, 103570. Article 103570. https://doi.org/10.1016/j.critrevonc.2021.103570

@article{96d3a0150ee04011b1426bad15144f57,

title = "Chemotherapy is superior to checkpoint inhibitors after radical surgery for urothelial carcinoma: a systematic review and network meta-analysis of oncologic and toxicity outcomes",

abstract = "Objective: To determine the oncologic and toxicity outcomes of adjuvant immunotherapy with immune checkpoint inhibitors (ICIs) compared to adjuvant chemotherapy in patients treated with radical surgery for urothelial carcinoma (UC). Methods: We used the Bayesian approach in the network meta-analysis of different therapy regimens compared to observation or placebo. Results: Nine studies comprised of 2,444 patients met the eligibility criteria. In bladder UC, chemotherapy, atezolizumab, and nivolumab did not improve disease progression compared to observation/placebo. In upper tract UC (UTUC), chemotherapy was significantly associated with a lower likelihood of disease progression compared to observation/placebo, while atezolizumab and nivolumab were not. Based on the analysis of the treatment ranking, adjuvant chemotherapy appeared as the best treatment approach in both bladder UC and UTUC. The risk of adverse events with ICIs was comparable to that of observation/placebo. Conclusion: Our analysis suggests a superior oncologic benefit to adjuvant chemotherapy over ICIs in patients treated with radical surgery for both bladder UC and UTUC.",

author = "Ekaterina Laukhtina and \{Sari Motlagh\}, Reza and Keiichiro Mori and Satoshi Katayama and Pawel Rajwa and Takafumi Yanagisawa and Fahad Quhal and Hadi Mostafaei and Grossmann, \{Nico C.\} and Frederik K{\"o}nig and Abdulmajeed Aydh and Benjamin Pradere and Irene Resch and Merseburger, \{Axel S.\} and Dmitry Enikeev and Shariat, \{Shahrokh F.\}",

note = "Publisher Copyright: {\textcopyright} 2021 The Author(s)",

year = "2022",

month = jan,

doi = "10.1016/j.critrevonc.2021.103570",

language = "English",

volume = "169",

pages = "103570",

journal = "Critical Reviews in Oncology/Hematology",

issn = "1040-8428",

publisher = "Elsevier Ireland Ltd",

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Laukhtina, E, Sari Motlagh, R, Mori, K, Katayama, S, Rajwa, P, Yanagisawa, T, Quhal, F, Mostafaei, H, Grossmann, NC, König, F, Aydh, A, Pradere, B, Resch, I, Merseburger, AS, Enikeev, D & Shariat, SF 2022, 'Chemotherapy is superior to checkpoint inhibitors after radical surgery for urothelial carcinoma: a systematic review and network meta-analysis of oncologic and toxicity outcomes', Critical Reviews in Oncology/Hematology, vol. 169, 103570, pp. 103570. https://doi.org/10.1016/j.critrevonc.2021.103570

Chemotherapy is superior to checkpoint inhibitors after radical surgery for urothelial carcinoma: a systematic review and network meta-analysis of oncologic and toxicity outcomes. / Laukhtina, Ekaterina; Sari Motlagh, Reza; Mori, Keiichiro et al.
In: Critical Reviews in Oncology/Hematology, Vol. 169, 103570, 01.2022, p. 103570.

Research output: Journal Articles › Scientific review articles › Research

TY - JOUR

T1 - Chemotherapy is superior to checkpoint inhibitors after radical surgery for urothelial carcinoma

T2 - a systematic review and network meta-analysis of oncologic and toxicity outcomes

AU - Laukhtina, Ekaterina

AU - Sari Motlagh, Reza

AU - Mori, Keiichiro

AU - Katayama, Satoshi

AU - Rajwa, Pawel

AU - Yanagisawa, Takafumi

AU - Quhal, Fahad

AU - Mostafaei, Hadi

AU - Grossmann, Nico C.

AU - König, Frederik

AU - Aydh, Abdulmajeed

AU - Pradere, Benjamin

AU - Resch, Irene

AU - Merseburger, Axel S.

AU - Enikeev, Dmitry

AU - Shariat, Shahrokh F.

PY - 2022/1

Y1 - 2022/1

N2 - Objective: To determine the oncologic and toxicity outcomes of adjuvant immunotherapy with immune checkpoint inhibitors (ICIs) compared to adjuvant chemotherapy in patients treated with radical surgery for urothelial carcinoma (UC). Methods: We used the Bayesian approach in the network meta-analysis of different therapy regimens compared to observation or placebo. Results: Nine studies comprised of 2,444 patients met the eligibility criteria. In bladder UC, chemotherapy, atezolizumab, and nivolumab did not improve disease progression compared to observation/placebo. In upper tract UC (UTUC), chemotherapy was significantly associated with a lower likelihood of disease progression compared to observation/placebo, while atezolizumab and nivolumab were not. Based on the analysis of the treatment ranking, adjuvant chemotherapy appeared as the best treatment approach in both bladder UC and UTUC. The risk of adverse events with ICIs was comparable to that of observation/placebo. Conclusion: Our analysis suggests a superior oncologic benefit to adjuvant chemotherapy over ICIs in patients treated with radical surgery for both bladder UC and UTUC.

AB - Objective: To determine the oncologic and toxicity outcomes of adjuvant immunotherapy with immune checkpoint inhibitors (ICIs) compared to adjuvant chemotherapy in patients treated with radical surgery for urothelial carcinoma (UC). Methods: We used the Bayesian approach in the network meta-analysis of different therapy regimens compared to observation or placebo. Results: Nine studies comprised of 2,444 patients met the eligibility criteria. In bladder UC, chemotherapy, atezolizumab, and nivolumab did not improve disease progression compared to observation/placebo. In upper tract UC (UTUC), chemotherapy was significantly associated with a lower likelihood of disease progression compared to observation/placebo, while atezolizumab and nivolumab were not. Based on the analysis of the treatment ranking, adjuvant chemotherapy appeared as the best treatment approach in both bladder UC and UTUC. The risk of adverse events with ICIs was comparable to that of observation/placebo. Conclusion: Our analysis suggests a superior oncologic benefit to adjuvant chemotherapy over ICIs in patients treated with radical surgery for both bladder UC and UTUC.

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UR - https://www.mendeley.com/catalogue/04c92c62-bf44-31e6-9d13-04a60a8b032a/

U2 - 10.1016/j.critrevonc.2021.103570

DO - 10.1016/j.critrevonc.2021.103570

M3 - Scientific review articles

C2 - 34902554

AN - SCOPUS:85121099887

SN - 1040-8428

VL - 169

SP - 103570

JO - Critical Reviews in Oncology/Hematology

JF - Critical Reviews in Oncology/Hematology

M1 - 103570

ER -

Chemotherapy is superior to checkpoint inhibitors after radical surgery for urothelial carcinoma: a systematic review and network meta-analysis of oncologic and toxicity outcomes

Abstract

Funding

UN SDGs

Research Areas and Centers

DFG Research Classification Scheme

Access to Document

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