Evidence map›Paper›PMID 41259899›Full record

ArticleESMO open2025

Outcomes of immune checkpoint inhibitor rechallenge in advanced urothelial carcinoma: results from a global real-world evidence study.

B A Maiorano, A Cigliola, V Tateo, C Mercinelli, G L Pastorino, N Dizman, H Ebrahimi, S K Pal, S Gupta, P Grivas and 4 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in ESMO open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

B A MaioranoDepartment of Medical Oncology, IRCCS San Raffaele Hospital, Milan, Italy. Electronic address: maiorano.brigida@hsr.it.
A CigliolaDepartment of Medical Oncology, IRCCS San Raffaele Hospital, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy.
V TateoDepartment of Medical Oncology, IRCCS San Raffaele Hospital, Milan, Italy.
C MercinelliDepartment of Medical Oncology, IRCCS San Raffaele Hospital, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy.
G L PastorinoVita-Salute San Raffaele University, Milan, Italy.
N DizmanThe University of Texas MD Anderson Cancer Center, Houston, USA; Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, USA.
H EbrahimiDepartment of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, USA.
S K PalDepartment of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, USA.
S GuptaTaussig Cancer Institute, Cleveland Clinic, Cleveland, USA.
P GrivasUniversity of Washington and Fred Hutchinson Cancer Center, Seattle, USA.
A M KamatMD Anderson Cancer Center, Houston, USA.
P E SpiessMoffitt Cancer Center, Tampa, USA.
N AgarwalHuntsman Cancer Institute, University of Utah, Salt Lake City, USA.
A NecchiDepartment of Medical Oncology, IRCCS San Raffaele Hospital, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSeveral immune checkpoint inhibitors (ICIs) are approved for urothelial carcinoma (UC), but limited information is currently available regarding the efficacy of rechallenging ICIs in patients with previous ICI exposure. PATIENTS AND

methodsA retrospective study was carried out using the TriNetX® database for a large-scale search of patients with advanced UC (aUC) who had received two separate courses of ICIs (either alone or in combinations). Kaplan-Meier analysis was used to estimate progression-free and overall survival (PFS, OS) of ICI rechallenge. Propensity score matching analysis was run to balance and compare groups based on the duration of ICI rechallenge and stage at diagnosis.

resultsOut of 35 789 patients, a cohort of 292 (0.81%) treated with ≥2 ICI-including lines between 2014 and 2024 was identified. There were 86% bladder versus 14% upper tract UC. At initial diagnosis, 49% had stage IV, whereas 51% had stage I-III disease. The median time on prior ICI treatment was 19.5 months; the median time from the end of ICI to the start of ICI rechallenge was 9.4 months. After a median follow-up of 21.7 months, the median OS of ICI rechallenge was 20.5 months, the median PFS was 10.3 months. Previous use of an ICI in a nonmetastatic setting was associated with longer median OS than both lines given in aUC (P < 0.001). Among those who received a previous ICI in a metastatic setting, a cut-off of 12 months for the ICI rechallenge was associated with a longer median OS (P = 0.027). The longest duration of rechallenge treatment was achieved with anti-programmed cell death protein 1 given after anti-programmed death-ligand 1 therapy (18.2 months, P < 0.001).

conclusionsAlthough it is an uncommon and not standard strategy, previous ICI in nonmetastatic UC and a period of ≥12 months after previous ICI in the metastatic setting were associated with better outcomes after ICI rechallenge in patients with aUC.

Indexed as

Carcinoma, Transitional CellImmune Checkpoint InhibitorsUrinary Bladder NeoplasmsUrologic NeoplasmsAgedAged, 80 and overFemaleHumansMaleMiddle AgedRetrospective StudiesTreatment OutcomeImmune Checkpoint Inhibitorsbladder cancerfirst-line therapyimmune checkpoint inhibitorsimmunotherapy rechallengereal-world data

Identifiers

PMID41259899
PMCPMC12670551

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.