Treatment Patterns for Metastatic Urothelial Carcinoma Across Eight Mexican Centers: The ALEBRIJE Study
PURPOSEMetastatic urothelial carcinoma (mUC) poses a challenge to health care systems, given its treatment complexity and mortality. We aimed to describe the characteristics, treatment patterns, and survival outcomes of Mexican patients with mUC.METHODSA retrospective study was conducted across eigh...
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American Society of Clinical Oncology
2025-04-01
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| Series: | JCO Global Oncology |
| Online Access: | https://ascopubs.org/doi/10.1200/GO-24-00431 |
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| author | Evelyn Lilian Beas-Lozano Yuly A. Remolina-Bonilla Rosa Caballero Nora Sobrevilla-Moreno Perla Perez-Perez Maria Guadalupe Díaz-Alvarado Omar Alejandro Zayas-Villanueva Erika Adriana Martinez-Castañeda Saul Campos-Gomez Luis Arturo Cardoso-Aparicio Dolores Mendoza-Oliva Maria T. Bourlon |
| author_facet | Evelyn Lilian Beas-Lozano Yuly A. Remolina-Bonilla Rosa Caballero Nora Sobrevilla-Moreno Perla Perez-Perez Maria Guadalupe Díaz-Alvarado Omar Alejandro Zayas-Villanueva Erika Adriana Martinez-Castañeda Saul Campos-Gomez Luis Arturo Cardoso-Aparicio Dolores Mendoza-Oliva Maria T. Bourlon |
| author_sort | Evelyn Lilian Beas-Lozano |
| collection | DOAJ |
| description | PURPOSEMetastatic urothelial carcinoma (mUC) poses a challenge to health care systems, given its treatment complexity and mortality. We aimed to describe the characteristics, treatment patterns, and survival outcomes of Mexican patients with mUC.METHODSA retrospective study was conducted across eight centers for adults with mUC from January /2001 to December 2021. We recorded medical history, eligibility for first-line platinum therapy, treatment lines received, and access to novel drugs. Descriptive statistics were used and survival analysis, including Kaplan-Meier curves and Cox proportional hazards model, was performed.RESULTSWe identified 379 patients with mUC; 37 were excluded, and 76% was male, with a median age of 67 years. The median follow-up was 8.4 months. Among those who received a first-line treatment (65%), cisplatin-based chemotherapy (45%) was the most common followed by carboplatin (39%). Causes of cisplatin ineligibility were Eastern Cooperative Oncology Group ≥2 (41%) and glomerular filtration rate <60 mL/min (33%). The overall response rate to up-front platinum therapy was 33%, with a median progression-free survival of 6.1 months (95% CI, 4.9 to 6.9). Second-, third-, and fourth-line treatment was given to 24.6%, 8.8%, and 3.5%, respectively. Chemotherapy was the most common regimen prescribed. Access to novel drugs was limited, 14 patients received avelumab, and 25% received immunotherapy as second-line treatment. The median overall survival was 11.8 months (95% CI, 10.2 to 15.2). Multivariate analysis showed that first-line treatment was independently associated with better survival, whereas poor performance status and visceral disease were associated with worse survival.CONCLUSIONTo our knowledge, these data represent the first effort to delineate treatment trends of mUC in Mexico. First-line treatment prescription and rates of progression to platinum therapy were higher than those described worldwide. Factors affecting survival included performance status, first-line treatment, and visceral disease. Our study highlights unequal access to novel treatments, underscoring the need for equitable care. |
| format | Article |
| id | doaj-art-9faedaef8b544d56ae196f0c77af6e5a |
| institution | OA Journals |
| issn | 2687-8941 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | American Society of Clinical Oncology |
| record_format | Article |
| series | JCO Global Oncology |
| spelling | doaj-art-9faedaef8b544d56ae196f0c77af6e5a2025-08-20T02:16:40ZengAmerican Society of Clinical OncologyJCO Global Oncology2687-89412025-04-011110.1200/GO-24-00431Treatment Patterns for Metastatic Urothelial Carcinoma Across Eight Mexican Centers: The ALEBRIJE StudyEvelyn Lilian Beas-Lozano0Yuly A. Remolina-Bonilla1Rosa Caballero2Nora Sobrevilla-Moreno3Perla Perez-Perez4Maria Guadalupe Díaz-Alvarado5Omar Alejandro Zayas-Villanueva6Erika Adriana Martinez-Castañeda7Saul Campos-Gomez8Luis Arturo Cardoso-Aparicio9Dolores Mendoza-Oliva10Maria T. Bourlon11Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, MexicoInstituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, MexicoInstituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, MexicoInstituto Nacional de Cancerologia, Mexico City, MexicoCentro Medico Nacional 20 de Noviembre, Mexico City, MexicoCentro Medico Nacional 20 de Noviembre, Mexico City, MexicoHospital Universitario “Dr José Eleuterio González,” Monterrey, MexicoMedica Sur, Mexico City, MexicoCentro Oncologico Estatal ISSEMYM, Toluca, MexicoHospital Central Militar, Mexico City, MexicoHospital Central Dr Ignacio Morones Prieto, San Luis Potosi, MexicoInstituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, MexicoPURPOSEMetastatic urothelial carcinoma (mUC) poses a challenge to health care systems, given its treatment complexity and mortality. We aimed to describe the characteristics, treatment patterns, and survival outcomes of Mexican patients with mUC.METHODSA retrospective study was conducted across eight centers for adults with mUC from January /2001 to December 2021. We recorded medical history, eligibility for first-line platinum therapy, treatment lines received, and access to novel drugs. Descriptive statistics were used and survival analysis, including Kaplan-Meier curves and Cox proportional hazards model, was performed.RESULTSWe identified 379 patients with mUC; 37 were excluded, and 76% was male, with a median age of 67 years. The median follow-up was 8.4 months. Among those who received a first-line treatment (65%), cisplatin-based chemotherapy (45%) was the most common followed by carboplatin (39%). Causes of cisplatin ineligibility were Eastern Cooperative Oncology Group ≥2 (41%) and glomerular filtration rate <60 mL/min (33%). The overall response rate to up-front platinum therapy was 33%, with a median progression-free survival of 6.1 months (95% CI, 4.9 to 6.9). Second-, third-, and fourth-line treatment was given to 24.6%, 8.8%, and 3.5%, respectively. Chemotherapy was the most common regimen prescribed. Access to novel drugs was limited, 14 patients received avelumab, and 25% received immunotherapy as second-line treatment. The median overall survival was 11.8 months (95% CI, 10.2 to 15.2). Multivariate analysis showed that first-line treatment was independently associated with better survival, whereas poor performance status and visceral disease were associated with worse survival.CONCLUSIONTo our knowledge, these data represent the first effort to delineate treatment trends of mUC in Mexico. First-line treatment prescription and rates of progression to platinum therapy were higher than those described worldwide. Factors affecting survival included performance status, first-line treatment, and visceral disease. Our study highlights unequal access to novel treatments, underscoring the need for equitable care.https://ascopubs.org/doi/10.1200/GO-24-00431 |
| spellingShingle | Evelyn Lilian Beas-Lozano Yuly A. Remolina-Bonilla Rosa Caballero Nora Sobrevilla-Moreno Perla Perez-Perez Maria Guadalupe Díaz-Alvarado Omar Alejandro Zayas-Villanueva Erika Adriana Martinez-Castañeda Saul Campos-Gomez Luis Arturo Cardoso-Aparicio Dolores Mendoza-Oliva Maria T. Bourlon Treatment Patterns for Metastatic Urothelial Carcinoma Across Eight Mexican Centers: The ALEBRIJE Study JCO Global Oncology |
| title | Treatment Patterns for Metastatic Urothelial Carcinoma Across Eight Mexican Centers: The ALEBRIJE Study |
| title_full | Treatment Patterns for Metastatic Urothelial Carcinoma Across Eight Mexican Centers: The ALEBRIJE Study |
| title_fullStr | Treatment Patterns for Metastatic Urothelial Carcinoma Across Eight Mexican Centers: The ALEBRIJE Study |
| title_full_unstemmed | Treatment Patterns for Metastatic Urothelial Carcinoma Across Eight Mexican Centers: The ALEBRIJE Study |
| title_short | Treatment Patterns for Metastatic Urothelial Carcinoma Across Eight Mexican Centers: The ALEBRIJE Study |
| title_sort | treatment patterns for metastatic urothelial carcinoma across eight mexican centers the alebrije study |
| url | https://ascopubs.org/doi/10.1200/GO-24-00431 |
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