Scientific Reports (Mar 2025)
Sex as modifier of survival in patients with advanced urothelial cancer treated with pembrolizumab
- Lorena Incorvaia,
- Sarah Scagliarini,
- Fernando Sabino Marques Monteiro,
- Hideki Takeshita,
- Jose Carlos Tapia,
- María Natalia Gandur Quiroga,
- Elaine Lam,
- Deniz Tural,
- Lazar Popovic,
- Saul Campos-Gomez,
- Paolo Andrea Zucali,
- Augusto Mota,
- Cinzia Ortega,
- Juan Pablo Sade,
- Mimma Rizzo,
- Ondřej Fiala,
- Nuno Vau,
- Patrizia Giannatempo,
- Halima Abahssain,
- Andrea Benedetto Galosi,
- Giuseppe Badalamenti,
- Jindrich Kopecky,
- Aristotelis Bamias,
- Johannes Landmesser,
- Jawaher Ansari,
- Fabio Calabrò,
- Francesco Massari,
- Sebastiano Buti,
- Joaquim Bellmunt,
- Matteo Santoni
Affiliations
- Lorena Incorvaia
- Department of Precision Medicine in Medical, Surgical and Critical Care (Me.Pre.C.C.), Section of Medical Oncology, University of Palermo
- Sarah Scagliarini
- UOC di Oncologia, Azienda Ospedaliera di Rilievo Nazionale Cardarelli di Napoli
- Fernando Sabino Marques Monteiro
- Latin American Cooperative Oncology Group - LACOG
- Hideki Takeshita
- Department of Urology, Saitama Medical Center, Saitama Medical University
- Jose Carlos Tapia
- Department of Medical Oncology, Institut d’Investigació Biomèdica Sant Pau, Hospital de la Santa Creu i Sant Pau
- María Natalia Gandur Quiroga
- Hospital Ángel H. Roffo, CABA
- Elaine Lam
- University of Colorado Anschutz Medical Campus
- Deniz Tural
- Department of Medical Oncology, Bakirköy Dr. SadiKonuk Training and Research Hospital
- Lazar Popovic
- Oncology Institute of Vojvodina, Faculty of Medicine, University Novi Sad
- Saul Campos-Gomez
- Centro Oncologico Estatal ISSEMYM
- Paolo Andrea Zucali
- Department of Oncology, IRCCS Humanitas Research Hospital
- Augusto Mota
- Clínica AMO
- Cinzia Ortega
- Michele and Pietro Ferrero Hospital - ASL CN2
- Juan Pablo Sade
- Instituto Alexander Fleming, CABA
- Mimma Rizzo
- Division of Medical Oncology, A.O.U. Consorziale Policlinico di Bari
- Ondřej Fiala
- Department of Oncology and Radiotherapeutics, Faculty of Medicine and University Hospital in Pilsen, Charles University
- Nuno Vau
- Urologic Oncology, Champalimaud Clinical Center
- Patrizia Giannatempo
- Dipartimento di Oncologia Medica, Fondazione IRCCS Istituto Nazionale dei Tumori
- Halima Abahssain
- Medical Oncology Unit, Medicine and Pharmacy Faculty, National Institute of Oncology, Mohamed V University
- Andrea Benedetto Galosi
- Urology Unit, Azienda Ospedaliero-Universitaria delle Marche, Università Politecnica delle Marche
- Giuseppe Badalamenti
- Department of Precision Medicine in Medical, Surgical and Critical Care (Me.Pre.C.C.), Section of Medical Oncology, University of Palermo
- Jindrich Kopecky
- Department of Clinical Oncology and Radiotherapy, University Hospital Hradec Kralove
- Aristotelis Bamias
- 2nd Propaedeutic Department of Internal Medicine, ATTIKON University Hospital, School of Medicine, National and Kapodistrian University of Athens
- Johannes Landmesser
- Klinik Für Urologie
- Jawaher Ansari
- Medical Oncology, Tawam Hospital
- Fabio Calabrò
- Medical Oncology 1, IRCCS Regina Elena National Cancer Institute
- Francesco Massari
- Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna
- Sebastiano Buti
- Medical Oncology Unit, University Hospital of Parma
- Joaquim Bellmunt
- Dana Farber Cancer Institute, Harvard Medical School
- Matteo Santoni
- Oncology Unit, Macerata Hospital
- DOI
- https://doi.org/10.1038/s41598-025-93094-2
- Journal volume & issue
-
Vol. 15,
no. 1
pp. 1 – 9
Abstract
Abstract Gender- and sex-based disparities in response to immune-checkpoint inhibitors (ICI) has been reported in a variety of tumor types. Women have different anatomy with recurrent urinary tract infections, a different sex hormonal profile, and intrinsic differences in local and systemic immune systems and urobiome composition. Existing literature data in a pan-cancer context reveal contradictory results, and real-world evidence in urothelial carcinoma (UC) is lacking. This was a real-world, multicenter, international, observational study to determine the sex effects on the clinical outcomes in metastatic urothelial carcinoma (mUC) patients progressing or recurring after platinum-based therapy and treated with pembrolizumab as a part of routine clinical care. A total of 1039 patients, treated from January 1st, 2016 to December 31st, 2023 in 68 cancer centers were included. Our data showed that women with metastatic urothelial carcinoma treated with pembrolizumab had shorter OS than men, with a 13% advantage in the 5-year OS rate for male patients. A deeper understanding of these results may inform sex-stratification in future prospective clinical trials and help develop strategies to reduce the magnitude of the sex disparities observed in urothelial cancer outcomes.
Keywords
