Impact of Divergent Differentiation and/or Histological Subtype of Urothelial Carcinoma on Patient Outcomes in the GETUG-AFU V05 VESPER Trial

No AccessJournal of UrologyOriginal Research Articles1 Apr 2024Impact of Divergent Differentiation and/or Histological Subtype of Urothelial Carcinoma on Patient Outcomes in the GETUG-AFU V05 VESPER TrialThis article is commented on by the following:Editorial CommentEditorial CommentEditorial Comment Yves Allory, Stephane Culine, Clémentine Krucker, Jacqueline Fontugne, Valentin Harter, and Christian Pfister Yves AlloryYves Allory Corresponding Author: Yves Allory, MD, Department of Pathology, Institut Curie, 35 Rue Dailly, St-Cloud92210, France ([email protected]) https://orcid.org/0000-0002-5526-077X , Stephane CulineStephane Culine , Clémentine KruckerClémentine Krucker , Jacqueline FontugneJacqueline Fontugne , Valentin HarterValentin Harter , and Christian PfisterChristian Pfister for the VESPER Trial Investigators View All Author Informationhttps://doi.org/10.1097/JU.0000000000003836AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Variant histology or divergent differentiation (VH/DD) of urothelial carcinoma (UC) may impact outcomes after neoadjuvant chemotherapy (NAC) in muscle-invasive bladder cancer. Our aim was to assess the pathological response and progression-free survival (PFS) of patients with VH/DD in the prospective VESPER clinical trial. Materials and Methods: This post hoc study included 300 NAC-treated patients with available transurethral diagnostic slides. Presence and percentage of VH/DDs were reviewed. For pathological response, logistic regression models were computed to measure association with VH/DD. For PFS, the associations were estimated in Cox proportional hazard regression model. All models were adjusted for randomization arm. Results: VH/DD was identified in 177/300 patients (59%) and was predominant (≥50%) in 85/177. Compared to pure UC, VH/DD (≥10% or ≥50%) was not associated with a difference in proportion of complete pathological response (ypT0N0; OR adjusted: 0.79, 95% CI 0.49-1.29), downstaging (≤ypT1N0; OR adjusted: 0.62, 95% CI 0.37-1.02), or with an increased hazard of PFS (HR adjusted: 1.24, 95% CI 0.83-1.85). 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Conflict of Interest Disclosures: The Authors have no conflicts of interest to disclose. Ethics Statement: In lieu of a formal ethics committee, the principles of the Helsinki Declaration were followed. Author Contributions:Conception and design: Allory, Culine, Harter, and Pfister. Preparation of the material for pathological review: Krucker. Pathological review: Allory. Data acquisition: Harter. Drafting the manuscript: Allory. Statistical analysis: Harter. All authors discussed and interpreted the results. All authors reviewed and approved the manuscript. Data Availability: The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request. Editor's Note: This article is the third of 5 published in this issue for which Category 1 CME credits can be earned. Instructions for obtaining credits are given with the questions on pages 641 and 642. © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited bySiemens D (2024) Editor's ChoiceJournal of Urology, VOL. 211, NO. 4, (507-508), Online publication date: 1-Apr-2024.Sundi D (2024) Editorial CommentJournal of Urology, VOL. 211, NO. 4, (574-574), Online publication date: 1-Apr-2024.Linscott J and Sexton W (2024) Editorial CommentJournal of Urology, VOL. 211, NO. 4, (573-574), Online publication date: 1-Apr-2024.Chou W and Chakiryan N (2024) Editorial CommentJournal of Urology, VOL. 211, NO. 4, (572-573), Online publication date: 1-Apr-2024.Related articlesJournal of Urology19 Jan 2024Editorial CommentJournal of Urology19 Jan 2024Editorial CommentJournal of Urology19 Jan 2024Editorial Comment Volume 211Issue 4April 2024Page: 564-574Supplementary Materials Peer Review Report Open Peer Review Report Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.Keywordsbladder cancerneoadjuvant chemotherapyurothelial carcinomahistological subtypesoutcomeAcknowledgmentsWe thank all VESPER trial investigators (G. Gravis, G. Pignot [Marseille]; J.P. Fendler, A. Fléchon [Lyon]; L. Guy, H. Mahammedi [Clermont Ferrand]; B. Laguerre, G. Verhoest [Rennes]; A. Guillot, N. Mottet [Saint-Etienne]; A. Doerfler, F. Joly [Caen]; S. Abadie-Lacourtoisie, A. Azzouzi [Angers]; P. Mongiat [Paris, Saint-Louis]; P. Eschwege, L. Geoffrois [Nancy]; F. Di Fiore [Rouen]; C. Chevreau, M. Soulié [Toulouse]; J.L. Hoepffner, G. Roubaud [Bordeaux]; P. Barthelemy, H. Lang [Strasbourg]; E. Mandron, E. Voog [Le Mans]; J.M. Tourani [Poitiers]; A. Colau, C. Serrrate [Paris, Diaconesses]; A. de La Taille, C. Saldana [Paris, Mondor]; F. Kleinclauss, T. Nguyen [Besançon]; J. Irani, Y. Loriot [Villejuif]; J.C. Eymard, S. Larre [Reims]; O. Huillard, M. Zerbib [Cochin]; J. Rigaud, F. Rolland [Nantes]; S. Droupy, N. Houede [Nimes]; G. Malouf, M. Roupret [Paris, Pitié-Salpetrière]; M. El Demery, C. Legon [La Seyne sur Mer]; N. Letang, S. Vieillot [Perpignan]; N. Gaschignard, T. Lharidon [La Roche sur Yon]; J.L. Davin, W. Hilgers [Avignon]) for their active participation and Nikki Sabourin-Gibbs, Rouen University Hospital, for her help in editing the manuscript.Metrics Author Information Yves Allory Corresponding Author: Yves Allory, MD, Department of Pathology, Institut Curie, 35 Rue Dailly, St-Cloud92210, France ([email protected]) More articles by this author Stephane Culine More articles by this author Clémentine Krucker More articles by this author Jacqueline Fontugne More articles by this author Valentin Harter More articles by this author Christian Pfister More articles by this author Expand All Funding/Support: The GETUG/AFU V05 VESPER randomized phase III study was supported by a grant from the French Ministry of Health (PHRC 2011-037) and ancillary study was supported by a grant from the French National Institute of Cancer (INCa) and French Ministry of Health (PRT-K 2016, BoBCaT). Conflict of Interest Disclosures: The Authors have no conflicts of interest to disclose. Ethics Statement: In lieu of a formal ethics committee, the principles of the Helsinki Declaration were followed. Author Contributions:Conception and design: Allory, Culine, Harter, and Pfister. Preparation of the material for pathological review: Krucker. Pathological review: Allory. Data acquisition: Harter. Drafting the manuscript: Allory. Statistical analysis: Harter. All authors discussed and interpreted the results. All authors reviewed and approved the manuscript. Data Availability: The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request. Editor's Note: This article is the third of 5 published in this issue for which Category 1 CME credits can be earned. Instructions for obtaining credits are given with the questions on pages 641 and 642. Advertisement PDF downloadLoading ...