Management Practices of Locally Advanced and Metastatic Urothelial Carcinoma: A Questionnaire-Based Survey among Lebanese Oncologists  

作　　者：Joseph Kattan Sally Temraz Fadi Nasr Arafat Tfayli Christina Khater Anas Mugharbel Hady Ghanem Hampig Raphael Kourie Georges Hachem Sarah Masri Jamil Debs Ali Shamseddine Joseph Kattan;Sally Temraz;Fadi Nasr;Arafat Tfayli;Christina Khater;Anas Mugharbel;Hady Ghanem;Hampig Raphael Kourie;Georges Hachem;Sarah Masri;Jamil Debs;Ali Shamseddine(Department of Hematology-Oncology, Hô,tel-Dieu de France University Hospital, Faculty of Medicine, Saint-Joseph University of Beirut, Beirut, Lebanon;Department of Internal Medicine, Hematology-Oncology Division, American University of Beirut Medical Center, Beirut, Lebanon;Hematology-Oncology Division, American University of Beirut Medical Center, Beirut, Lebanon;Department of Hematology-Oncology, Saint Charles Hospital, Beirut, Lebanon;Department of Internal Medicine, Makassed General Hospital, Beirut, Lebanon;Hematology-Oncology Division, Lebanese American University Medical Center - Rizk Hospital, Beirut, Lebanon;Department of Hematology-Oncology, Saint George Hospital University Medical Center, Beirut, Lebanon;Pfizer Medical Affairs, Beirut, Lebanon)

机构地区：[1]Department of Hematology-Oncology, Hô,tel-Dieu de France University Hospital, Faculty of Medicine, Saint-Joseph University of Beirut, Beirut, Lebanon [2]Department of Internal Medicine, Hematology-Oncology Division, American University of Beirut Medical Center, Beirut, Lebanon [3]Hematology-Oncology Division, American University of Beirut Medical Center, Beirut, Lebanon [4]Department of Hematology-Oncology, Saint Charles Hospital, Beirut, Lebanon [5]Department of Internal Medicine, Makassed General Hospital, Beirut, Lebanon [6]Hematology-Oncology Division, Lebanese American University Medical Center - Rizk Hospital, Beirut, Lebanon [7]Department of Hematology-Oncology, Saint George Hospital University Medical Center, Beirut, Lebanon [8]Pfizer Medical Affairs, Beirut, Lebanon

出　　处：《Open Journal of Urology》2024年第2期138-149,共12页泌尿学期刊（英文）

摘　　要：Background and Objective: The outcome of locally advanced and metastatic urothelial carcinoma LA/mUC has improved over the past years with a plethora of new treatments and the approval of immune checkpoint inhibitors (ICIs), antibody-drug conjugates, and targeted agents, to identify locally advanced metastatic urothelial carcinoma’s current management practices in Lebanon and the implication of the ongoing economic crisis on the medical practice. Methods: An online questionnaire was used to survey ten Lebanese oncologists from six different hospitals, between July 5 and July 11, 2022, requesting information pertaining to their current clinical practice in the pharmacological treatment of locally advanced metastatic urothelial carcinoma. Key Findings: Cisplatin-based chemotherapy was the most frequently reported initial treatment of locally advanced metastatic urothelial carcinoma. Participants reported using immune checkpoint inhibitors in platinum-ineligible patients and those with PDL1 positive tumors. Also, they would not consider the concomitant use of immunotherapy and chemotherapy in the first-line setting. Participants believed that avelumab maintenance is effective in the absence of progression after first-line platinum-based chemotherapy;they would consider initiating it 2 - 10 weeks after completion of chemotherapy. Conclusions and Clinical Implications: After comparing with current international guidelines, this study shows that Lebanese oncologists follow international guidelines and have deep knowledge of recent clinical trials for the management of locally advanced metastatic urothelial carcinoma, regardless of economic crisis challenges.Background and Objective: The outcome of locally advanced and metastatic urothelial carcinoma LA/mUC has improved over the past years with a plethora of new treatments and the approval of immune checkpoint inhibitors (ICIs), antibody-drug conjugates, and targeted agents, to identify locally advanced metastatic urothelial carcinoma’s current management practices in Lebanon and the implication of the ongoing economic crisis on the medical practice. Methods: An online questionnaire was used to survey ten Lebanese oncologists from six different hospitals, between July 5 and July 11, 2022, requesting information pertaining to their current clinical practice in the pharmacological treatment of locally advanced metastatic urothelial carcinoma. Key Findings: Cisplatin-based chemotherapy was the most frequently reported initial treatment of locally advanced metastatic urothelial carcinoma. Participants reported using immune checkpoint inhibitors in platinum-ineligible patients and those with PDL1 positive tumors. Also, they would not consider the concomitant use of immunotherapy and chemotherapy in the first-line setting. Participants believed that avelumab maintenance is effective in the absence of progression after first-line platinum-based chemotherapy;they would consider initiating it 2 - 10 weeks after completion of chemotherapy. Conclusions and Clinical Implications: After comparing with current international guidelines, this study shows that Lebanese oncologists follow international guidelines and have deep knowledge of recent clinical trials for the management of locally advanced metastatic urothelial carcinoma, regardless of economic crisis challenges.

关 键 词：Clinical Practice Chemotherapy Immune Checkpoint Inhibitors PDL1 Urothelial Carcinoma 

分 类 号：R73[医药卫生—肿瘤]