Response to checkpoint blockade in patients with upper tract urothelial carcinoma and lynch syndrome

You have accessJournal of UrologyCME1 Apr 2023MP69-15 RESPONSE TO CHECKPOINT BLOCKADE IN PATIENTS WITH UPPER TRACT UROTHELIAL CARCINOMA AND LYNCH SYNDROME Alexander Doudt, Wesley Yip, Daniel Sjoberg, Gopa Iyer, Min Teo, and Jonathan Coleman Alexander DoudtAlexander Doudt More articles by this author , Wesley YipWesley Yip More articles by this author , Daniel SjobergDaniel Sjoberg More articles by this author , Gopa IyerGopa Iyer More articles by this author , Min TeoMin Teo More articles by this author , and Jonathan ColemanJonathan Coleman More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003332.15AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Immune checkpoint inhibition (ICI) has shown effective results in treating Lynch Syndrome (LS)-associated and microsatellite instability-high (MSI-H) malignancies. However, there is a paucity of information evaluating its use in patients with LS-associated upper tract urothelial carcinoma (UTUC). Our objective was to describe our clinical experience in treating LS-associated UTUC with checkpoint blockade. METHODS: All patients with LS-associated or MSI-H UTUC who received treatment with ICI at Memorial Sloan Kettering were retrospectively identified. Demographic and clinicopathological characteristics were collected. Patient outcomes were illustrated using a swimmer’s plot beginning at the initiation of ICI. For patients with metastatic disease, response to therapy was assessed by radiographic progression. For localized disease, pathologic response and time to urothelial recurrence were summarized. RESULTS: We identified 10 patients with LS-associated UTUC, 6 with metastatic and 4 with localized disease, who were treated with ICI (2015 to present). Seven patients had solitary kidneys [prior nephroureterectomy (NU)]. Two patients received ICI as neoadjuvant treatment prior to NU. Of the 4 patients with localized disease, 75% (3/4) had a complete response, including ypT0 after NU (2) and clinically pT0 based on endoscopic, cytologic, and radiographic findings. Median follow-up of the localized cohort was 5.6 months. One patient had urothelial recurrence at 6 months that was successfully treated with endoscopic ablation. Of the 6 patients with metastatic disease, 67% (4/6) were progression-free at 24-months. CONCLUSIONS: These preliminary findings provide supporting evidence for prospective studies to further assess the safety and efficacy of ICI for LS-associated UTUC in settings such as neoadjuvant therapy and as an organ-sparing option for patients with a solitary kidney. Source of Funding: MSKCC Sidney Kimmel Center for Prostate and Urologic Cancers © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e970 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Alexander Doudt More articles by this author Wesley Yip More articles by this author Daniel Sjoberg More articles by this author Gopa Iyer More articles by this author Min Teo More articles by this author Jonathan Coleman More articles by this author Expand All Advertisement PDF downloadLoading ...