Prognostic Impact of Adjuvant Immunotherapy in Patients with High-Risk Upper Tract Urothelial Cancer: Results from the ROBUUST 2.0 Collaborative Group

Maxwell Otiato; Farshad Sheybaee Moghaddam; Alireza Ghoreifi; Riccardo Autorino; Gabriele Bignante; Chandru Sundaram; Daniel Sidhom; Ithaar H. Derweesh; Dhruv Puri; Vitaly Margulis; Benjamin Popokh; Firas Abdollah; Alex Stephens; Matteo Ferro; Giuseppe Simone; Gabriele Tuderti; Reza Mehrazin; Ahmed Eraky; Mark Gonzalgo; Omar Falik Nativ; Zhenjie Wu; Francesco Porpiglia; Enrico N. Checcucci; Andres Correa; Randall Lee; Alessandro Antonelli; Alessandro Veccia; Soroush Rais-Bahrami; Alireza Dehghanmanshadi; Nirmish Singla; Stephan Brönimann; Sisto Perdonà; Roberto Contieri; Takashi Yoshida; James Porter; Saum Ghodoussipour; Luca Lambertini; Andrea Minervini; Hooman Djaladat

doi:10.3390/cancers17132144

Prognostic Impact of Adjuvant Immunotherapy in Patients with High-Risk Upper Tract Urothelial Cancer: Results from the ROBUUST 2.0 Collaborative Group

Maxwell Otiato
, Farshad Sheybaee Moghaddam
, Alireza Ghoreifi
, Riccardo Autorino
, Gabriele Bignante
, Chandru Sundaram
, Daniel Sidhom
, Ithaar H. Derweesh
, Dhruv Puri
, Vitaly Margulis
, Benjamin Popokh
, Firas Abdollah
, Alex Stephens
, Matteo Ferro
, Giuseppe Simone
, Gabriele Tuderti
, Reza Mehrazin
, Ahmed Eraky
, Mark Gonzalgo
, Omar Falik Nativ

Zhenjie Wu, Francesco Porpiglia, Enrico N. Checcucci, Andres Correa, Randall Lee, Alessandro Antonelli, Alessandro Veccia, Soroush Rais-Bahrami, Alireza Dehghanmanshadi, Nirmish Singla, Stephan Brönimann, Sisto Perdonà, Roberto Contieri, Takashi Yoshida, James Porter, Saum Ghodoussipour, Luca Lambertini, Andrea Minervini, Hooman Djaladat

University of Southern California
Rush University
Indiana University
University of California at San Diego
University of Texas Southwestern Medical Center
Henry Ford Health System
University of Milan
IRCCS Istituti fisioterapici ospitalieri - Istituto Regina Elena
Icahn School of Medicine at Mount Sinai
University of Miami
Second Military Medical University
IRCCS Fondazione del Piemonte per l'Oncologia - Candiolo (TO)
Fox Chase Cancer Center
University of Verona
University of Alabama at Birmingham
Johns Hopkins University
IRCCS Istituto nazionale tumori Fondazione Giovanni Pascale - Napoli
Kansai Medical University
Swedish Medical Center
Rutgers - The State University of New Jersey, New Brunswick
University of Florence

Research output: Contribution to journal › Article › peer-review

1 Scopus citations

Abstract

Background/Objective: The impact of adjuvant immunotherapy (IO) on the prognosis of patients with upper tract urothelial carcinoma (UTUC) remains unclear. This study examines the association of adjuvant IO with oncologic outcomes in patients with high-risk UTUC. Methods: This retrospective study reviewed patients with high-risk UTUC treated with adjuvant IO using the ROBotic surgery for Upper tract Urothelial cancer STudy (ROBUUST) database. Propensity-score-matched analysis (nearest-neighbor algorithm, caliper 0.1) was conducted to compare patients receiving adjuvant IO versus those who did not, with matching based on pathologic T and N category and receipt of neoadjuvant chemotherapy. Associations between adjuvant IO and urothelial recurrence-free survival (URFS), non-urothelial recurrence-free survival (NRFS), and overall survival (OS) were estimated using a Cox proportional hazards model. Results: Seventy-five patients received adjuvant IO following nephroureterectomy (median four cycles, including eleven (14.7%) nivolumab, thirty-one (41.3%) pembrolizumab, four (5.3%) atezolizumab, and twenty-nine (38.6%) other agents. These patients were matched to 68 patients without adjuvant therapy. Median follow-up times were 17 (IQR, 10–29) months and 20 (9–44) months for IO and no adjuvant therapy, respectively. Multivariable analysis revealed that adjuvant IO was not associated with URFS, NRFS, or OS. Pathologic nodal involvement (HR 7.52, p < 0.001) was the only independent predictor of worse OS. Conclusions: In this real-world retrospective data set, adjuvant IO does not have an impact on oncologic outcomes of UTUC patients following extirpative surgery.

Original language	English
Article number	2144
Journal	Cancers
Volume	17
Issue number	13
DOIs	https://doi.org/10.3390/cancers17132144
State	Published - Jul 2025

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

immunotherapy
nephroureterectomy
outcomes
upper tract urothelial carcinoma

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10.3390/cancers17132144

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Otiato, M., Moghaddam, F. S., Ghoreifi, A., Autorino, R., Bignante, G., Sundaram, C., Sidhom, D., Derweesh, I. H., Puri, D., Margulis, V., Popokh, B., Abdollah, F., Stephens, A., Ferro, M., Simone, G., Tuderti, G., Mehrazin, R., Eraky, A., Gonzalgo, M., ... Djaladat, H. (2025). Prognostic Impact of Adjuvant Immunotherapy in Patients with High-Risk Upper Tract Urothelial Cancer: Results from the ROBUUST 2.0 Collaborative Group. Cancers, 17(13), Article 2144. https://doi.org/10.3390/cancers17132144

@article{8006fdbc2e7c4bed8d5af623288d7ff6,

title = "Prognostic Impact of Adjuvant Immunotherapy in Patients with High-Risk Upper Tract Urothelial Cancer: Results from the ROBUUST 2.0 Collaborative Group",

abstract = "Background/Objective: The impact of adjuvant immunotherapy (IO) on the prognosis of patients with upper tract urothelial carcinoma (UTUC) remains unclear. This study examines the association of adjuvant IO with oncologic outcomes in patients with high-risk UTUC. Methods: This retrospective study reviewed patients with high-risk UTUC treated with adjuvant IO using the ROBotic surgery for Upper tract Urothelial cancer STudy (ROBUUST) database. Propensity-score-matched analysis (nearest-neighbor algorithm, caliper 0.1) was conducted to compare patients receiving adjuvant IO versus those who did not, with matching based on pathologic T and N category and receipt of neoadjuvant chemotherapy. Associations between adjuvant IO and urothelial recurrence-free survival (URFS), non-urothelial recurrence-free survival (NRFS), and overall survival (OS) were estimated using a Cox proportional hazards model. Results: Seventy-five patients received adjuvant IO following nephroureterectomy (median four cycles, including eleven (14.7\%) nivolumab, thirty-one (41.3\%) pembrolizumab, four (5.3\%) atezolizumab, and twenty-nine (38.6\%) other agents. These patients were matched to 68 patients without adjuvant therapy. Median follow-up times were 17 (IQR, 10–29) months and 20 (9–44) months for IO and no adjuvant therapy, respectively. Multivariable analysis revealed that adjuvant IO was not associated with URFS, NRFS, or OS. Pathologic nodal involvement (HR 7.52, p < 0.001) was the only independent predictor of worse OS. Conclusions: In this real-world retrospective data set, adjuvant IO does not have an impact on oncologic outcomes of UTUC patients following extirpative surgery.",

keywords = "immunotherapy, nephroureterectomy, outcomes, upper tract urothelial carcinoma",

author = "Maxwell Otiato and Moghaddam, \{Farshad Sheybaee\} and Alireza Ghoreifi and Riccardo Autorino and Gabriele Bignante and Chandru Sundaram and Daniel Sidhom and Derweesh, \{Ithaar H.\} and Dhruv Puri and Vitaly Margulis and Benjamin Popokh and Firas Abdollah and Alex Stephens and Matteo Ferro and Giuseppe Simone and Gabriele Tuderti and Reza Mehrazin and Ahmed Eraky and Mark Gonzalgo and Nativ, \{Omar Falik\} and Zhenjie Wu and Francesco Porpiglia and Checcucci, \{Enrico N.\} and Andres Correa and Randall Lee and Alessandro Antonelli and Alessandro Veccia and Soroush Rais-Bahrami and Alireza Dehghanmanshadi and Nirmish Singla and Stephan Br{\"o}nimann and Sisto Perdon{\`a} and Roberto Contieri and Takashi Yoshida and James Porter and Saum Ghodoussipour and Luca Lambertini and Andrea Minervini and Hooman Djaladat",

note = "Publisher Copyright: {\textcopyright} 2025 by the authors.",

year = "2025",

month = jul,

doi = "10.3390/cancers17132144",

language = "English",

volume = "17",

journal = "Cancers",

issn = "2072-6694",

publisher = "Multidisciplinary Digital Publishing Institute (MDPI)",

number = "13",

}

Otiato, M, Moghaddam, FS, Ghoreifi, A, Autorino, R, Bignante, G, Sundaram, C, Sidhom, D, Derweesh, IH, Puri, D, Margulis, V, Popokh, B, Abdollah, F, Stephens, A, Ferro, M, Simone, G, Tuderti, G, Mehrazin, R, Eraky, A, Gonzalgo, M, Nativ, OF, Wu, Z, Porpiglia, F, Checcucci, EN, Correa, A, Lee, R, Antonelli, A, Veccia, A, Rais-Bahrami, S, Dehghanmanshadi, A, Singla, N, Brönimann, S, Perdonà, S, Contieri, R, Yoshida, T, Porter, J, Ghodoussipour, S, Lambertini, L, Minervini, A & Djaladat, H 2025, 'Prognostic Impact of Adjuvant Immunotherapy in Patients with High-Risk Upper Tract Urothelial Cancer: Results from the ROBUUST 2.0 Collaborative Group', Cancers, vol. 17, no. 13, 2144. https://doi.org/10.3390/cancers17132144

TY - JOUR

T1 - Prognostic Impact of Adjuvant Immunotherapy in Patients with High-Risk Upper Tract Urothelial Cancer

T2 - Results from the ROBUUST 2.0 Collaborative Group

AU - Otiato, Maxwell

AU - Moghaddam, Farshad Sheybaee

AU - Ghoreifi, Alireza

AU - Autorino, Riccardo

AU - Bignante, Gabriele

AU - Sundaram, Chandru

AU - Sidhom, Daniel

AU - Derweesh, Ithaar H.

AU - Puri, Dhruv

AU - Margulis, Vitaly

AU - Popokh, Benjamin

AU - Abdollah, Firas

AU - Stephens, Alex

AU - Ferro, Matteo

AU - Simone, Giuseppe

AU - Tuderti, Gabriele

AU - Mehrazin, Reza

AU - Eraky, Ahmed

AU - Gonzalgo, Mark

AU - Nativ, Omar Falik

AU - Wu, Zhenjie

AU - Porpiglia, Francesco

AU - Checcucci, Enrico N.

AU - Correa, Andres

AU - Lee, Randall

AU - Antonelli, Alessandro

AU - Veccia, Alessandro

AU - Rais-Bahrami, Soroush

AU - Dehghanmanshadi, Alireza

AU - Singla, Nirmish

AU - Brönimann, Stephan

AU - Perdonà, Sisto

AU - Contieri, Roberto

AU - Yoshida, Takashi

AU - Porter, James

AU - Ghodoussipour, Saum

AU - Lambertini, Luca

AU - Minervini, Andrea

AU - Djaladat, Hooman

PY - 2025/7

Y1 - 2025/7

N2 - Background/Objective: The impact of adjuvant immunotherapy (IO) on the prognosis of patients with upper tract urothelial carcinoma (UTUC) remains unclear. This study examines the association of adjuvant IO with oncologic outcomes in patients with high-risk UTUC. Methods: This retrospective study reviewed patients with high-risk UTUC treated with adjuvant IO using the ROBotic surgery for Upper tract Urothelial cancer STudy (ROBUUST) database. Propensity-score-matched analysis (nearest-neighbor algorithm, caliper 0.1) was conducted to compare patients receiving adjuvant IO versus those who did not, with matching based on pathologic T and N category and receipt of neoadjuvant chemotherapy. Associations between adjuvant IO and urothelial recurrence-free survival (URFS), non-urothelial recurrence-free survival (NRFS), and overall survival (OS) were estimated using a Cox proportional hazards model. Results: Seventy-five patients received adjuvant IO following nephroureterectomy (median four cycles, including eleven (14.7%) nivolumab, thirty-one (41.3%) pembrolizumab, four (5.3%) atezolizumab, and twenty-nine (38.6%) other agents. These patients were matched to 68 patients without adjuvant therapy. Median follow-up times were 17 (IQR, 10–29) months and 20 (9–44) months for IO and no adjuvant therapy, respectively. Multivariable analysis revealed that adjuvant IO was not associated with URFS, NRFS, or OS. Pathologic nodal involvement (HR 7.52, p < 0.001) was the only independent predictor of worse OS. Conclusions: In this real-world retrospective data set, adjuvant IO does not have an impact on oncologic outcomes of UTUC patients following extirpative surgery.

AB - Background/Objective: The impact of adjuvant immunotherapy (IO) on the prognosis of patients with upper tract urothelial carcinoma (UTUC) remains unclear. This study examines the association of adjuvant IO with oncologic outcomes in patients with high-risk UTUC. Methods: This retrospective study reviewed patients with high-risk UTUC treated with adjuvant IO using the ROBotic surgery for Upper tract Urothelial cancer STudy (ROBUUST) database. Propensity-score-matched analysis (nearest-neighbor algorithm, caliper 0.1) was conducted to compare patients receiving adjuvant IO versus those who did not, with matching based on pathologic T and N category and receipt of neoadjuvant chemotherapy. Associations between adjuvant IO and urothelial recurrence-free survival (URFS), non-urothelial recurrence-free survival (NRFS), and overall survival (OS) were estimated using a Cox proportional hazards model. Results: Seventy-five patients received adjuvant IO following nephroureterectomy (median four cycles, including eleven (14.7%) nivolumab, thirty-one (41.3%) pembrolizumab, four (5.3%) atezolizumab, and twenty-nine (38.6%) other agents. These patients were matched to 68 patients without adjuvant therapy. Median follow-up times were 17 (IQR, 10–29) months and 20 (9–44) months for IO and no adjuvant therapy, respectively. Multivariable analysis revealed that adjuvant IO was not associated with URFS, NRFS, or OS. Pathologic nodal involvement (HR 7.52, p < 0.001) was the only independent predictor of worse OS. Conclusions: In this real-world retrospective data set, adjuvant IO does not have an impact on oncologic outcomes of UTUC patients following extirpative surgery.

KW - immunotherapy

KW - nephroureterectomy

KW - outcomes

KW - upper tract urothelial carcinoma

UR - https://www.scopus.com/pages/publications/105010585287

U2 - 10.3390/cancers17132144

DO - 10.3390/cancers17132144

M3 - Article

C2 - 40647441

AN - SCOPUS:105010585287

SN - 2072-6694

VL - 17

JO - Cancers

JF - Cancers

IS - 13

M1 - 2144

ER -

Prognostic Impact of Adjuvant Immunotherapy in Patients with High-Risk Upper Tract Urothelial Cancer: Results from the ROBUUST 2.0 Collaborative Group

Abstract

UN SDGs

Keywords

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