Current Systemic Treatment Options in Metastatic Urothelial Carcinoma after Progression on Checkpoint Inhibition Therapy—A Systemic Review Combined with Single-Group Meta-Analysis of Three Studies Testing Enfortumab Vedotin

摘要

Currently, little is known about what therapeutic options exist for the treatment of metastatic urothelial carcinoma (mUC) after a therapy with checkpoint inhibitors (CPI). In the context of this systemic review, five therapy regimens tested in the post-CPI setting with adequate data were identified: Chemotherapy (CT), Ramucirumab plus Docetaxel, Erdafitinib (Erd), Enfortumab vedotin (EV), and Sacituzumab govitecan (SG). Most data were available on EV, and the results of three studies testing the agent were combined via single-group meta-analysis. For EV, the objective response rate was 42.1% compared to 17.9% for CT in a similar setting. EV was also ahead in progression-free survival (5.9 months with EV vs. 3.7 months with CT) and overall survival (12.8 months with EV vs. 9.0 months with CT). Further research is needed on the question of which patients’ subcollectives particularly benefit from which therapeutic approach.