Objective: To analyze the clinical efficacy and safety of toripalimab combined with the GC chemotherapy regimen in the treatment of advanced urothelial carcinoma. Methods: A retrospective study was conducted on 102 patients with advanced urothelial carcinoma treated at our hospital between March 2021 and August 2024. Based on treatment regimens, patients were divided into a chemotherapy group (n = 52) and a combination group (n = 50). The chemotherapy group received the GC chemotherapy regimen, while the combination group received GC chemotherapy combined with toripalimab. Both groups underwent 4–6 cycles of treatment based on patient tolerance. Clinical efficacy, immune-related factor levels, survival outcomes, and safety were observed and compared. Results: The disease control rate (DCR) and overall response rate (ORR) in the combination group were slightly higher than those in the chemotherapy group, but the differences were not statistically significant (P > 0.05). After treatment, levels of IFN-γ and IL-2 increased significantly, while VEGF levels decreased significantly in both groups (P < 0.05), with superior outcomes observed in the combination group (P < 0.05). Follow-up analysis showed progression-free survival (PFS) and median overall survival (OS) in the chemotherapy group were 5.19 and 10.15 months, respectively, compared to 8.24 and 18.23 months in the combination group, with statistically significant differences (P < 0.05). During treatment, the incidence of adverse reactions such as rash, immune-related pneumonia, and immune-related diarrhea was higher in the combination group than in the chemotherapy group (P < 0.05). However, the incidence of gastrointestinal reactions, fever, and leukopenia did not differ significantly between the two groups (P > 0.05). Conclusion: The use of toripalimab combined with the GC chemotherapy regimen for advanced urothelial carcinoma can effectively improve clinical outcomes and extend patient survival, with good overall safety. However, attention should be given to preventing adverse reactions such as rash and pneumonia during treatment.
Gandhi J, Chen JF, Al-Ahmadie H, 2022, Urothelial Carcinoma: Divergent Differentiation and Morphologic Subtypes. Surg Pathol Clin, 15(4): 641–659. https://doi.org/10.1016/j.path.2022.07.003
Coleman JA, Yip W, Wong NC, et al., 2023, Multicenter Phase II Clinical Trial of Gemcitabine and Cisplatin as Neoadjuvant Chemotherapy for Patients With High-Grade Upper Tract Urothelial Carcinoma. J Clin Oncol, 41(8): 1618–1625. https://doi.org/10.1200/JCO.22.00763
Uccello M, Adeleke S, Moschetta M, et al., 2023, Immunotherapy for Advanced Urothelial Carcinoma (UC): Rational and Current Evidence. Ann Palliat Med, 12(6): 1345–1354. https://doi.org/10.21037/apm-22-1350
Liu W, Shen H, 2023, Efficacy of PD-1 Monoclonal Antibody Combined with GC Chemotherapy in the Treatment of Advanced Urothelial Carcinoma and Its Impact on Tumor Malignancy. Chongqing Medicine, 52(21): 3274–3278 + 3282.
Xu L, Zhang C, Wang D, et al., 2023, Neoadjuvant Immunotherapy Combined with Chemotherapy Followed by Surgical Treatment of Locally Advanced Upper Urinary Tract Urothelial Carcinoma: A Case Report. Practical Oncology Journal, 38(5): 476–480.
Yang X, Wu Y, 2004, RECIST Criteria for Evaluating the Efficacy of Solid Tumor Treatments. Evidence-based Medicine, 4(2): 25–30.
Xiang Y, 2024, Prognostic Significance of Urea and Immune-Inflammatory Markers in Advanced Urothelial Carcinoma Treated with Immunotherapy, dissertation, Jilin University.
Li H, Chen H, Wang L, et al., 2024, Nutritional Risk and Influencing Factors During Chemotherapy in Patients with Urothelial Carcinoma. Tumor Metabolism and Nutrition Electronic Journal, 11(1): 60–64.
Liu T, 2018, The Impact of Kushen Injection Combined with GC Chemotherapy on Chemotherapy Tolerance and Median Survival in Patients with Advanced Bladder Cancer. Drug Evaluation, 15(9): 35–38.
Wu X, Deng J, Luo T, 2024, Efficacy of Toripalimab Combined with Lenvatinib TACE in the Treatment of Advanced Liver Cancer and Its Impact on Tumor Markers for Prognosis. Hebei Medicine, 30(10): 1745–1751.
Li M, Han M, Li Z, 2023, Clinical Observation of Hepatic Arterial Chemoembolization Combined with Toripalimab in the Treatment of Liver Cancer. Tianjin Pharmacy, 35(3): 53–56.
Xie Q, 2024, Efficacy of Different Chemotherapy Regimens in the Treatment of Advanced Urothelial Carcinoma and Their Impact on Immune Function. Jilin Medical Journal, 45(2): 276–279.