Response to Vinflunine Treatment after Prior Platinum-Based Chemotherapy in Patients with Advanced Urothelial Carcinoma Independent of Primary Tumor Location

e15536 Background: The outcome of chemotherapy in patients with metastatic urothelial carcinoma (UC) of the upper tract (UT) is generally assumed to be worse compared to bladder as a primary location. However, prospective data on the response to a cytotoxic agent in UTUC are scarce. Here we present data from a non-interventional study of patients with UTUC and lower tract UC (LTUC) treated with vinflunine after failure of platinum-based chemotherapy. Methods: Data were prospectively collected on platinum-pretreated UC patients undergoing vinflunine treatment in 39 German hospitals or outpatient units. Dosing of vinflunine, tumor assessments and concomitant medications were performed according to physician’s usual practice. Results: Out of 77 patients recruited UC was located in the UT in 18 patients (23 %) and the LT in 59 patients (77 %). Performance status in both groups was comparable (Karnofsky index 83.9 % vs. 83.7 %) and patients with UTUC were on average four years older (68.2 y vs. 64.4 y). The main grade 3/4 toxicities in the overall population, UTUC and LTUC patients were leucopenia 16.9/27.8/13.6 %, anemia 6.5/5.6/6.8 %, elevated liver enzymes 6.5/5.6/6.8 % and constipation 5.2/0/6.8 %. Efficacy was comparable in the UTUC and LTUC group regarding the overall response rate (22.2 % vs. 23.7 %), disease control rate (50.0 % vs. 54.2 %) and progression-free survival (2.76 [CI 1.38-8.28] months vs. 2.76 [CI 2.27-3.38] months). Conclusions: This prospective study confirms that vinflunine provides meaningful benefits with a good safety profile to patients pretreated with a platinum-based regimen in both advanced/metastatic UTUC and LTUC in routine practice. These findings support further application of vinflunine in UTUC patients.