HER2-targeting antibody-drug conjugate RC48 alone or in combination with immunotherapy for locally advanced or metastatic urothelial carcinoma: a multicenter, real-world study

Cancer Immunol Immunother. 2023 Jul;72(7):2309-2318. doi: 10.1007/s00262-023-03419-1. Epub 2023 Mar 10.

Abstract

Background: Phase II trials showed the efficacy of anti-HER2 RC48-ADC (disitamab vedotin) for HER2-positive metastatic urothelial carcinoma (UC). This study evaluated RC48 alone verses in combination with immunotherapy for locally advanced or metastatic UC using real-world data.

Methods: This retrospective, multicenter, real-world study included patients with locally advanced or metastatic UC who received RC48 in five hospitals in China between July 2021 and April 2022. The outcomes were progression-free survival (PFS), overall survival (OS), objective response rate (ORR), disease control rate (DCR), and adverse events.

Results: Thirty-six patients were included. The patients were 47-87 years, and 26 (72.2%) were male. Eighteen patients received RC48 alone, and 18 received RC48 combined with a programmed death-1 antibody. The median PFS was 5.4 months. The median OS was not reached. The 6-month and 1-year PFS rates were 38.8% and 15.5%, respectively. The 1-year OS rate was 79.6%. Fourteen (38.9%) patients achieved a partial response, and the ORR was 38.9%. Eleven patients had stable disease, and the DCR was 69.4%. The median PFS for patients who received RC48 combined with immunotherapy and those who received RC48 alone was 8.5 and 5.4 months, respectively. The main treatment-related adverse events included anemia, hypoesthesia, fatigue, and elevated transaminase. No treatment-related death occurred.

Conclusion: RC48 alone or combined with immunotherapy might benefit patients with locally advanced or metastatic UC, regardless of impaired renal function.

Keywords: Anti-HER2 antibody–drug conjugate; Metastatic urothelial carcinoma; RC48; Real-world study.

Publication types

  • Multicenter Study

MeSH terms

  • Antineoplastic Agents* / therapeutic use
  • Carcinoma, Transitional Cell* / drug therapy
  • Female
  • Humans
  • Immunoconjugates* / therapeutic use
  • Immunotherapy
  • Male
  • Retrospective Studies
  • Urinary Bladder Neoplasms* / drug therapy

Substances

  • Immunoconjugates
  • disitamab vedotin
  • Antineoplastic Agents