Observational studyFrontiers in immunology2026
Adjuvant disitamab vedotin plus PD-1 blockade and gemcitabine/cisplatin in high-risk upper tract urothelial carcinoma: a two-stage real-world comparative study.
Observational study in Frontiers in immunology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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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.
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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.
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Who cites it
1 citing paper in PubMed.
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Authors and funding
16 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Objectives: To evaluate real-world effectiveness and safety of adjuvant disitamab vedotin plus PD-1 blockade (ADC+ICI) versus gemcitabine/cisplatin (GC) in high-risk upper tract urothelial carcinoma after radical nephroureterectomy. Patients and methods: This single-center, two-stage observational study enrolled 421 patients with study-defined high-risk upper tract urothelial carcinoma. Cohort A evaluated adjuvant GC versus surgery alone using propensity score matching. Cohort B compared adjuvant GC with ADC+ICI using overlap weighting, with ECOG performance status and three-level HER2 IHC category included in covariate adjustment. Overall survival (OS), conventional disease-free survival (DFS), non-intravesical progression-free survival (PFS), intravesical recurrence-free survival (IVRFS), safety, and exploratory HER2-stratified outcomes were assessed. Results: In Cohort A, adjuvant GC was associated with improved OS after matching. In Cohort B, 48 patients received GC and 53 received ADC+ICI. After overlap weighting, baseline covariates were well balanced. ADC+ICI was not associated with a significant OS improvement versus GC (HR 0.47, 95% CI 0.12-1.89; P = 0.287; FDR-adjusted P = 0.403). Directionally favorable associations were observed for conventional DFS (HR 0.32, 95% CI 0.11-0.96; nominal P = 0.043; FDR-adjusted P = 0.172), non-intravesical PFS (HR 0.32, 95% CI 0.09-1.18; P = 0.086), and IVRFS (HR 0.21, 95% CI 0.04-1.09; P = 0.063). HER2 IHC 2+/3+ tumors showed exploratory favorable DFS/PFS signals. Grade ≥3 treatment-related adverse events were similar between groups. Conclusions: Adjuvant ADC+ICI showed comparable short-term OS and directionally favorable DFS/PFS trends versus GC, with a distinct toxicity profile. These findings are hypothesis-generating and require prospective validation.
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