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

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Open Journal of Urology 2024年第2期14卷 138-149页

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 Department of Hematology-Oncology H&#244tel-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

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

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