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3. Novel Classification for Upper Tract Urothelial Carcinoma to Better Risk-stratify Patients Eligible for Kidney-sparing Strategies: An International Collaborative Study

Author

Marcq, Gautier, Foerster, Beat, Abufaraj, Mohammad, Matin, Surena F., Azizi, Mounsif, Gupta, Mohit, Li, Wei-Ming, Seisen, Thomas, Clinton, Timothy, Xylinas, Evanguelos, Mir, M. Carmen, Schweitzer, Donald, Mari, Andrea, Kimura, Shoji, Bandini, Marco, Mathieu, Romain, Ku, Ja H., Guruli, Georgi, Grabbert, Markus, Czech, Anna K., Muilwijk, Tim, Pycha, Armin, D’Andrea, David, Petros, Firas G., Spiess, Philippe E., Bivalacqua, Trinity, Wu, Wen-Jeng, Rouprêt, Morgan, Krabbe, Laura-Maria, Hendricksen, Kees, Egawa, Shin, Briganti, Alberto, Moschini, Marco, Graffeille, Vivien, Autorino, Riccardo, John, Patricia, Heidenreich, Axel, Chlosta, Piotr, Joniau, Steven, Soria, Francesco, Pierorazio, Phillip M., Shariat, Shahrokh F., and Kassouf, Wassim

Published
2022
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23. Pretreatment Risk Stratification for Endoscopic Kidney-sparing Surgery in Upper Tract Urothelial Carcinoma: An International Collaborative Study

Author

Foerster, Beat, primary, Abufaraj, Mohammad, additional, Matin, Surena F., additional, Azizi, Mounsif, additional, Gupta, Mohit, additional, Li, Wei-Ming, additional, Seisen, Thomas, additional, Clinton, Timothy, additional, Xylinas, Evanguelos, additional, Mir, M. Carmen, additional, Schweitzer, Donald, additional, Mari, Andrea, additional, Kimura, Shoji, additional, Bandini, Marco, additional, Mathieu, Romain, additional, Ku, Ja H., additional, Marcq, Gautier, additional, Guruli, Georgi, additional, Grabbert, Markus, additional, Czech, Anna K., additional, Muilwijk, Tim, additional, Pycha, Armin, additional, D’Andrea, David, additional, Petros, Firas G., additional, Spiess, Philippe E., additional, Bivalacqua, Trinity, additional, Wu, Wen-Jeng, additional, Rouprêt, Morgan, additional, Krabbe, Laura-Maria, additional, Hendricksen, Kees, additional, Egawa, Shin, additional, Briganti, Alberto, additional, Moschini, Marco, additional, Graffeille, Vivien, additional, Kassouf, Wassim, additional, Autorino, Riccardo, additional, Heidenreich, Axel, additional, Chlosta, Piotr, additional, Joniau, Steven, additional, Soria, Francesco, additional, Pierorazio, Phillip M., additional, and Shariat, Shahrokh F., additional

Published
2021
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24. Long-Term Outcomes of Whole Gland Salvage Cryotherapy for Locally Recurrent Prostate Cancer following Radiation Therapy: A Combined Analysis of Two Centers

Author

Chin, Joseph L., primary, Lavi, Arnon, additional, Metcalfe, Michael J., additional, Siddiqui, Khuram, additional, Dewar, Malcolm, additional, Petros, Firas G., additional, Li, Roger, additional, Nogueras González, Graciela M., additional, Wang, Xuemei, additional, Nair, Shiva M., additional, Ward, John F., additional, and Pisters, Louis, additional

Published
2021
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27. Predictive model for systemic recurrence following cisplatin-based neoadjuvant chemotherapy and radical nephroureterectomy for high risk upper tract urothelial carcinoma

Author

Ghandour, Rashed A., primary, Freifeld, Yuval, additional, Cheaib, Joseph, additional, Singla, Nirmish, additional, Meng, Xiaosong, additional, Kenigsberg, Alexander, additional, Bagrodia, Aditya, additional, Woldu, Solomon, additional, Hoffman-Censits, Jean, additional, Enikeev, Dmitry, additional, Rapoport, Leonid, additional, Petros, Firas G., additional, Raman, Jay D., additional, Pierorazio, Philip M., additional, Matin, Surena F., additional, and Margulis, Vitaly, additional

Published
2021
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28. Pretreatment Risk Stratification for Endoscopic Kidney-sparing Surgery in Upper Tract Urothelial Carcinoma: An International Collaborative Study

Author

Foerster, Beat, Abufaraj, Mohammad, Matin, Surena F., Azizi, Mounsif, Gupta, Mohit, Li, Wei-Ming, Seisen, Thomas, Clinton, Timothy, Xylinas, Evanguelos, Mir, M. Carmen, Schweitzer, Donald, Mari, Andrea, Kimura, Shoji, Bandini, Marco, Mathieu, Romain, Ku, Ja H., Marcq, Gautier, Guruli, Georgi, Grabbert, Markus, Czech, Anna K., Muilwijk, Tim, Pycha, Armin, D'Andrea, David, Petros, Firas G., Spiess, Philippe E., Bivalacqua, Trinity, Wu, Wen-Jeng, Roupret, Morgan, Krabbe, Laura-Maria, Hendricksen, Kees, Egawa, Shin, Briganti, Alberto, Moschini, Marco, Graffeille, Vivien, Kassouf, Wassim, Autorino, Riccardo, Heidenreich, Axel, Chlosta, Piotr, Joniau, Steven, Soria, Francesco, Pierorazio, Phillip M., Shariat, Shahrokh F., Foerster, Beat, Abufaraj, Mohammad, Matin, Surena F., Azizi, Mounsif, Gupta, Mohit, Li, Wei-Ming, Seisen, Thomas, Clinton, Timothy, Xylinas, Evanguelos, Mir, M. Carmen, Schweitzer, Donald, Mari, Andrea, Kimura, Shoji, Bandini, Marco, Mathieu, Romain, Ku, Ja H., Marcq, Gautier, Guruli, Georgi, Grabbert, Markus, Czech, Anna K., Muilwijk, Tim, Pycha, Armin, D'Andrea, David, Petros, Firas G., Spiess, Philippe E., Bivalacqua, Trinity, Wu, Wen-Jeng, Roupret, Morgan, Krabbe, Laura-Maria, Hendricksen, Kees, Egawa, Shin, Briganti, Alberto, Moschini, Marco, Graffeille, Vivien, Kassouf, Wassim, Autorino, Riccardo, Heidenreich, Axel, Chlosta, Piotr, Joniau, Steven, Soria, Francesco, Pierorazio, Phillip M., and Shariat, Shahrokh F.

Abstract

Background: Several groups have proposed features to identify low-risk patients who may benefit from endoscopic kidney-sparing surgery in upper tract urothelial carcinoma (UTUC). Objective: To evaluate standard risk stratification features, develop an optimal model to identify >= pT2/N+ stage at radical nephroureterectomy (RNU), and compare it with the existing unvalidated models. Design, setting, and participants: This was a collaborative retrospective study that included 1214 patients who underwent ureterorenoscopy with biopsy followed by RNU for nonmetastatic UTUC between 2000 and 2017. Outcome measurements and statistical analysis: We performed multiple imputation of chained equations for missing data and multivariable logistic regression analysis with a stepwise selection algorithm to create the optimal predictive model. The area under the curve and a decision curve analysis were used to compare the models. Results and limitations: Overall, 659 (54.3%) and 555 (45.7%) patients had <= pT1N0/Nx and >= pT2/N+ disease, respectively. In the multivariable logistic regression analysis of our model, age (odds ratio [OR] 1.02, 95% confidence interval [CI] 1.0-1.03, p = 0.013), high-grade biopsy (OR 1.81, 95% CI 1.37-2.40, p < 0.001), biopsy cT1+ staging (OR 3.23, 95% CI 1.93-5.41, p < 0.001), preoperative hydronephrosis (OR 1.37 95% CI 1.04-1.80, p = 0.024), tumor size (OR 1.09, 95% CI 1.01-1.17, p = 0.029), invasion on imaging (OR 5.10, 95% CI 3.32-7.81, p < 0.001), and sessile architecture (OR 2.31, 95% CI 1.58-3.36, p < 0.001) were significantly associated with >= pT2/pN+ disease. Compared with the existing models, our model had the highest performance accuracy (75% vs 66-71%) and an additional clinical net reduction (four per 100 patients). Conclusions: Our proposed risk-stratification model predicts the risk of harboring >= pT2/N+ UTUC with reliable accuracy and a clinical net benefit outperforming the current risk-stratification models. Patient summary: We develop

Published
2021

29. Impact of Sex on Response to Neoadjuvant Chemotherapy in Patients with Upper-tract Urothelial Cancer

Author

D’Andrea, David, Foerster, Beat, Matin, Surena F., Ku, Ja H., Muilwijk, Tim, Monteiro, Leonardo L., Liao, Ross, Petros, Firas G., Spiess, Philippe E., Bivalacqua, Trinity J., Hendricksen, Kees, van Rhijn, Bas W.G., Shabsigh, Ahmad, Briganti, Alberto, Joniau, Steven, Kassouf, Wassim, Pierorazio, Phillip M., Margulis, Vitaly, Necchi, Andrea, and Shariat, Shahrokh F.

Published
2020
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30. Pathologic stage as a surrogate for oncologic outcomes after receipt of neoadjuvant chemotherapy for high-grade upper tract urothelial carcinoma

Author

Singla, Nirmish, primary, Christie, Alana, additional, Freifeld, Yuval, additional, Ghandour, Rashed A., additional, Woldu, Solomon L., additional, Clinton, Timothy N., additional, Petros, Firas G., additional, Robyak, Haley, additional, Yeh, Hsin-Chih, additional, Fang, Dong, additional, Enikeev, Dmitry, additional, Bagrodia, Aditya, additional, Sagalowsky, Arthur I., additional, Lotan, Yair, additional, Raman, Jay D., additional, Matin, Surena F., additional, and Margulis, Vitaly, additional

Published
2020
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34. Comparative effectiveness of neoadjuvant chemotherapy in bladder and upper urinary tract urothelial carcinoma

Author

D’Andrea, David, primary, Matin, Surena, additional, Black, Peter C., additional, Petros, Firas G., additional, Zargar, Homayoun, additional, Dinney, Colin P., additional, Cookson, Michael S., additional, Kassouf, Wassim, additional, Dall'Era, Marc A., additional, McGrath, John S., additional, Wright, Jonathan L., additional, Thorpe, Andrew C., additional, Morgan, Todd M., additional, Holzbeierlein, Jeffrey M., additional, Bivalacqua, Trinity J., additional, Sridhar, Srikala S., additional, North, Scott, additional, Barocas, Daniel A., additional, Lotan, Yair, additional, Stephenson, Andrew J., additional, van Rhijn, Bas W., additional, Spiess, Philippe E., additional, Daneshmand, Siamak, additional, and Shariat, Shahrokh F., additional

Published
2020
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35. Intraoperative prophylactic intravesical chemotherapy to reduce bladder recurrence following radical nephroureterectomy

Author

Freifeld, Yuval, primary, Ghandour, Rashed, additional, Singla, Nirmish, additional, Woldu, Solomon, additional, Bagrodia, Aditya, additional, Lotan, Yair, additional, Rapoport, Leonid M., additional, Gazimiev, Magomet, additional, Delafuente, Karen, additional, Kulangara, Rohan, additional, Robyak, Haley, additional, Petros, Firas G., additional, Raman, Jay D., additional, Matin, Surena F., additional, and Margulis, Vitaly, additional

Published
2020
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37. Clinical Evaluation of Avelumab in the Treatment of Advanced Urothelial Carcinoma: Focus on Patient Selection and Outcomes.

Author

Eyck, Jennifer E Ten, Kahlon, Navkirat, Masih, Sonia, Hamouda, Danae M, and Petros, Firas G

Subjects
TRANSITIONAL cell carcinoma, PATIENT selection, DISEASE risk factors, TREATMENT effectiveness, PROGNOSIS, BLADDER cancer, CHRONIC active hepatitis
Abstract

Background: First-line therapy for treatment of advanced urothelial carcinoma includes combination platinum-based chemotherapies, though resistance and long-term toxicity concerns to these regimens cause limitations in progression-free survival and overall survival. Maintenance treatment with an alternative agent such as the PD-L1 inhibitor, avelumab (Bavencio®), after initial chemotherapy has been shown to prolong overall survival. The aim of this review is to provide a landscape clinical use of avelumab in the treatment of advanced urothelial carcinoma with a focus on patient selection and outcomes. Methods: This review includes the most up to date phases and results from clinical trials published in peer-reviewed journals. Results: Three studies were included, one phase 1B trial, one phase 1B trial with 2 year follow-up, and one phase 3 trial. Patients receiving avelumab maintenance therapy at 10 mg/kg IV every two weeks had an overall better performance status, though those with an increased ECOG-PS, increased Bellmunt risk score, or failure of ≥ 3 chemotherapies had poorer responses. Patients over the age of 65 had a higher ORR (18– 25%) compared to younger patients (13– 14%). Patients with PD-L1 positive tumors had a significantly increased CR median ORR (13.8%), median PFS (5.7 months), and median 12-month OS rate (79.1%) compared to control subjects receiving best supportive care (1.2%, 2.1 months, 60.4%, respectively). TRAEs were seen in 86.7% of patients, with 32.4% of patients experiencing a ≥grade 3 AE. The most common AE was IRR (32.4%, ≥grade 3 1.01%) and irAE 25.6% of any grade, including various rashes and pruritus AEs, immune-related thyroid disorders, and immune related hepatitis. There were 3 reported treatment-related deaths (0.05%). Ongoing phases of one of the trials is investigating the use of docetaxel and avelumab together after failure of one chemotherapy. Conclusion: Avelumab as a maintenance therapy after platinum-based chemotherapy failure or in platinum-ineligible patients with advanced or metastatic urothelial carcinoma is an effective option with increased ORR, PFS, and OS with a similar safety profile to other chemotherapies. Ongoing studies currently in recruitment and active clinical trials will yield valuable insights into optimizing avelumab therapy in conjunction with chemotherapies and/or immunotherapies, better characterization of response for PD-L1 positive tumors, and a clearer insight into clinically validated prognostic factors to improve patient outcomes. [ABSTRACT FROM AUTHOR]

Published
2022
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41. Preoperative predictive model and nomogram for disease recurrence following radical nephroureterectomy for high grade upper tract urothelial carcinoma

Author

Freifeld, Yuval, primary, Ghandour, Rashed, additional, Singla, Nirmish, additional, Woldu, Solomon, additional, Clinton, Timothy, additional, Kulangara, Rohan, additional, Bagrodia, Aditya, additional, Matin, Surena F., additional, Petros, Firas G., additional, Raman, Jay D., additional, Robyak, Haley, additional, Yan, Jingsheng, additional, Zhu, Hong, additional, Rapoport, Leonid, additional, Lotan, Yair, additional, and Margulis, Vitaly, additional

Published
2019
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44. Comparative effectiveness of neoadjuvant chemotherapy in bladder and upper urinary tract urothelial carcinoma.

Author

D'Andrea, David, Matin, Surena, Black, Peter C., Petros, Firas G., Zargar, Homayoun, Dinney, Colin P., Cookson, Michael S., Kassouf, Wassim, Dall'Era, Marc A., McGrath, John S., Wright, Jonathan L., Thorpe, Andrew C., Morgan, Todd M., Holzbeierlein, Jeffrey M., Bivalacqua, Trinity J., Sridhar, Srikala S., North, Scott, Barocas, Daniel A., Lotan, Yair, and Stephenson, Andrew J.

Subjects
BLADDER, NEOADJUVANT chemotherapy, TRANSITIONAL cell carcinoma, URINARY organs, LOGISTIC regression analysis, BRACHIAL plexus block, URINARY diversion
Abstract

Objective: To assess the differential response to neoadjuvant chemotherapy (NAC) in patients with urothelial carcinoma of the bladder (UCB) compared to upper tract urothelial carcioma (UTUC) treated with radical surgery. Patients and Methods: Data from 1299 patients with UCB and 276 with UTUC were obtained from multicentric collaborations. The association of disease location (UCB vs UTUC) with pathological complete response (pCR, defined as a post‐treatment pathological stage ypT0N0) and pathological objective response (pOR, defined as ypT0‐Ta‐Tis‐T1N0) after NAC was evaluated using logistic regression analyses. The association with overall (OS) and cancer‐specific survival (CSS) was evaluated using Cox regression analyses. Results: A pCR was found in 250 (19.2%) patients with UCB and in 23 (8.3%) with UTUC (P < 0.01). A pOR was found in 523 (40.3%) patients with UCB and in 133 (48.2%) with UTUC (P = 0.02). On multivariable logistic regression analysis, patients with UTUC were less likely to have a pCR (odds ratio [OR] 0.45, 95% confidence interval [CI] 0.27–0.70; P < 0.01) and more likely to have a pOR (OR 1.57, 95% CI 1.89–2.08; P < 0.01). On univariable Cox regression analyses, UTUC was associated with better OS (hazard ratio [HR] 0.80, 95% CI 0.64–0.99, P = 0.04) and CSS (HR 0.63, 95% CI 0.49–0.83; P < 0.01). On multivariable Cox regression analyses, UTUC remained associated with CSS (HR 0.61, 95% CI 0.45–0.82; P < 0.01), but not with OS. Conclusions: Our present findings suggest that the benefit of NAC in UTUC is similar to that found in UCB. These data can be used as a benchmark to contextualise survival outcomes and plan future trial design with NAC in urothelial cancer. [ABSTRACT FROM AUTHOR]

Published
2021
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47. Intraoperative Conversion From Partial to Radical Nephrectomy: Incidence, Predictive Factors, and Outcomes

Author

Petros, Firas G., primary, Keskin, Sarp K., additional, Yu, Kai-Jie, additional, Li, Roger, additional, Metcalfe, Michael J., additional, Fellman, Bryan M., additional, Chang, Courtney M., additional, Gu, Cindy, additional, Tamboli, Pheroze, additional, Matin, Surena F., additional, Karam, Jose A., additional, and Wood, Christopher G., additional

Published
2018
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