What Did the Research Discover?
This study evaluated the effectiveness of nivolumab combined with gemcitabine–cisplatin compared to gemcitabine–cisplatin alone in patients with previously untreated advanced urothelial carcinoma. The research found that patients receiving the nivolumab combination had significantly longer overall survival (21.7 months vs. 18.9 months) and progression-free survival (7.9 months vs. 7.6 months) compared to those on chemotherapy alone. The combination treatment also resulted in a higher overall response rate (57.6% vs. 43.1%) and more complete responses (21.7% vs. 11.8%).
The duration of complete response was nearly three times longer in the nivolumab combination group (37.1 months) than in the chemotherapy-only group (13.2 months). While the nivolumab combination improved survival outcomes, it also led to a higher rate of grade 3 or higher adverse events (61.8% vs. 51.7%). Despite this, health-related quality of life remained stable in both treatment groups.
How Can I Apply This Research?
For patients with advanced urothelial carcinoma, this study suggests that adding nivolumab to standard cisplatin-based chemotherapy may provide a better chance of prolonged survival and deeper, longer-lasting responses compared to chemotherapy alone. Those eligible for cisplatin treatment might consider discussing the potential benefits and risks of this combination therapy with their oncologists.
While the findings indicate a significant improvement in outcomes, side effects were more common in the nivolumab group. Patients should weigh the potential for longer survival against the risk of increased adverse events. Since this study supports the benefit of combining immunotherapy with chemotherapy, it may influence future treatment guidelines for metastatic urothelial carcinoma.
Source:
Van Der Heijden MS, Sonpavde G, Powles T, Necchi A, Burotto M, Schenker M, Sade JP, Bamias A, Beuzeboc P, Bedke J, Oldenburg J. Nivolumab plus gemcitabine–cisplatin in advanced urothelial carcinoma. New England Journal of Medicine. 2023 Nov 9;389(19):1778-89. https://www.nejm.org/doi/10.1056/NEJMoa2309863?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed
