{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T13:51:30Z","timestamp":1753883490441,"version":"3.41.2"},"reference-count":34,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"11","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Glob Oncol"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:sec>\n            <jats:title>PURPOSE<\/jats:title>\n            <jats:p>Metastatic urothelial carcinoma (mUC) poses a challenge to health care systems, given its treatment complexity and mortality. We aimed to describe the characteristics, treatment patterns, and survival outcomes of Mexican patients with mUC.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS<\/jats:title>\n            <jats:p>A retrospective study was conducted across eight centers for adults with mUC from January \/2001 to December 2021. We recorded medical history, eligibility for first-line platinum therapy, treatment lines received, and access to novel drugs. Descriptive statistics were used and survival analysis, including Kaplan-Meier curves and Cox proportional hazards model, was performed.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS<\/jats:title>\n            <jats:p>We identified 379 patients with mUC; 37 were excluded, and 76% was male, with a median age of 67 years. The median follow-up was 8.4 months. Among those who received a first-line treatment (65%), cisplatin-based chemotherapy (45%) was the most common followed by carboplatin (39%). Causes of cisplatin ineligibility were Eastern Cooperative Oncology Group \u22652 (41%) and glomerular filtration rate &lt;60 mL\/min (33%). The overall response rate to up-front platinum therapy was 33%, with a median progression-free survival of 6.1 months (95% CI, 4.9 to 6.9). Second-, third-, and fourth-line treatment was given to 24.6%, 8.8%, and 3.5%, respectively. Chemotherapy was the most common regimen prescribed. Access to novel drugs was limited, 14 patients received avelumab, and 25% received immunotherapy as second-line treatment. The median overall survival was 11.8 months (95% CI, 10.2 to 15.2). Multivariate analysis showed that first-line treatment was independently associated with better survival, whereas poor performance status and visceral disease were associated with worse survival.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSION<\/jats:title>\n            <jats:p>To our knowledge, these data represent the first effort to delineate treatment trends of mUC in Mexico. First-line treatment prescription and rates of progression to platinum therapy were higher than those described worldwide. Factors affecting survival included performance status, first-line treatment, and visceral disease. Our study highlights unequal access to novel treatments, underscoring the need for equitable care.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1200\/go-24-00431","type":"journal-article","created":{"date-parts":[[2025,1,2]],"date-time":"2025-01-02T20:59:11Z","timestamp":1735851551000},"update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":0,"title":["Treatment Patterns for Metastatic Urothelial Carcinoma Across Eight Mexican Centers: The ALEBRIJE Study"],"prefix":"10.1200","author":[{"given":"Evelyn Lilian","family":"Beas-Lozano","sequence":"first","affiliation":[{"name":"Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n, Mexico City, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2388-5844","authenticated-orcid":true,"given":"Yuly A.","family":"Remolina-Bonilla","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n, Mexico City, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2841-2993","authenticated-orcid":true,"given":"Rosa","family":"Caballero","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n, Mexico City, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5035-2854","authenticated-orcid":true,"given":"Nora","family":"Sobrevilla-Moreno","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Cancerologia, Mexico City, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Perla","family":"Perez-Perez","sequence":"additional","affiliation":[{"name":"Centro Medico Nacional 20 de Noviembre, Mexico City, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Guadalupe","family":"D\u00edaz-Alvarado","sequence":"additional","affiliation":[{"name":"Centro Medico Nacional 20 de Noviembre, Mexico City, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6953-2425","authenticated-orcid":true,"given":"Omar Alejandro","family":"Zayas-Villanueva","sequence":"additional","affiliation":[{"name":"Hospital Universitario \u201cDr Jos\u00e9 Eleuterio Gonz\u00e1lez,\u201d Monterrey, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erika Adriana","family":"Martinez-Casta\u00f1eda","sequence":"additional","affiliation":[{"name":"Medica Sur, Mexico City, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1804-2589","authenticated-orcid":true,"given":"Saul","family":"Campos-Gomez","sequence":"additional","affiliation":[{"name":"Centro Oncologico Estatal ISSEMYM, Toluca, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-7770-6154","authenticated-orcid":true,"given":"Luis Arturo","family":"Cardoso-Aparicio","sequence":"additional","affiliation":[{"name":"Hospital Central Militar, Mexico City, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dolores","family":"Mendoza-Oliva","sequence":"additional","affiliation":[{"name":"Hospital Central Dr Ignacio Morones Prieto, San Luis Potosi, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3116-912X","authenticated-orcid":true,"given":"Maria T.","family":"Bourlon","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n, Mexico City, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"233","reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21834"},{"volume-title":"Cancer Today","key":"e_1_3_6_3_2","unstructured":"Cancer Today. https:\/\/gco.iarc.who.int\/today\/"},{"volume-title":"CI5 XII","key":"e_1_3_6_4_2","unstructured":"CI5 XII. https:\/\/ci5.iarc.fr\/ci5-xii\/"},{"key":"e_1_3_6_5_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1999.17.10.3173"},{"key":"e_1_3_6_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2007.10.069"},{"key":"e_1_3_6_7_2","first-page":"51","article-title":"The real-world lifetime economic burden of urothelial carcinoma by stage at diagnosis","volume":"6","author":"Aly A","year":"2020","unstructured":"Aly A, Johnson C, Doleh Y, et al: The real-world lifetime economic burden of urothelial carcinoma by stage at diagnosis. 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