{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T07:02:09Z","timestamp":1770447729444,"version":"3.49.0"},"reference-count":37,"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":[[2025,7]]},"abstract":"<jats:sec>\n                    <jats:title>PURPOSE<\/jats:title>\n                    <jats:p>Our investigation assessed the impact of geographical disparities in the treatment of patients with advanced urothelial cancer (aUC) included in the international, real-world ARON-2 trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PATIENTS AND METHODS<\/jats:title>\n                    <jats:p>The study population comprised 1,137 patients with aUC treated with pembrolizumab for relapsed or progressive disease after platinum-based chemotherapy (PBC) at 63 institutions in 19 countries. Patients were divided into three geographical areas: Europe (area 1: 791 patients), the United States (area 2: 156 patients), and Asia (area 3: 190 patients). Clinicopathologic and treatment data were extracted from medical records. The primary end points were to identify differences in patient and treatment characteristics and to assess overall survival (OS) and progression-free survival (PFS) between the three areas.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      There were differences in patient characteristics: more patients age 70 years and older in area 1; more patients with BMI \u226525 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      , squamous histotype, and T1 neoplasia at diagnosis in area 2; and more pure urothelial carcinoma in area 3. There were differences in treatment characteristics: Bacillus Calmette-Gu\u00e9rin instillations and primary tumor surgery were more common in area 1; neoadjuvant and adjuvant PBC, third-line therapies, and specifically enfortumab vedotin (EV) were less common in area 1. Median OS (mOS) from pembrolizumab initiation was 13.0 months in area 1, 29.1 months in area 2 and 13.2 months in area 3 (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001), and median PFS was 4.8 months, 5.2 months, and 3.8 months, respectively (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .002). In patients receiving EV after progression to PBC and pembrolizumab, mOS was 44.1 months in area 1, 31.7 months in area 2, and 23.8 months in area 3 (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .267).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>Real-world data suggest that facilitating and extending access to targeted therapies for patients with aUC in different geographical areas worldwide may lead to a consistent and widespread survival increase.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/go-24-00564","type":"journal-article","created":{"date-parts":[[2025,7,8]],"date-time":"2025-07-08T15:59:09Z","timestamp":1751990349000},"update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":0,"title":["Geographical Differences in the Management and Outcomes of Patients With Advanced Urothelial Carcinoma Treated With Pembrolizumab After Progression on Platinum-Based Chemotherapy: Results From ARON-2 Study"],"prefix":"10.1200","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7743-741X","authenticated-orcid":true,"given":"Mimma","family":"Rizzo","sequence":"first","affiliation":[{"name":"Medical Oncology Unit, Azienda Ospedaliera Universitaria Consorziale Policlinico di Bari, Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4980-6729","authenticated-orcid":true,"given":"Andrey","family":"Soares","sequence":"additional","affiliation":[{"name":"Department of Oncology, Hospital Israelita Albert Einstein, S\u00e3o Paulo, Brazil"},{"name":"Latin American Cooperative Oncology Group (LACOG), Porto Alegre, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8775-503X","authenticated-orcid":true,"given":"Shilpa","family":"Gupta","sequence":"additional","affiliation":[{"name":"Genitourinary Medical Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabio","family":"Calabr\u00f2","sequence":"additional","affiliation":[{"name":"Medical Oncology 1, IRCCS Regina Elena National Cancer Institute, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1512-6904","authenticated-orcid":true,"given":"Hideki","family":"Takeshita","sequence":"additional","affiliation":[{"name":"Department of Urology, Saitama Medical Center, Saitama Medical University, Saitama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3116-912X","authenticated-orcid":true,"given":"Maria Teresa","family":"Bourlon","sequence":"additional","affiliation":[{"name":"Department of Hemato-Oncology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico"},{"name":"Universidad Panamericana, Escuela de Medicina, Mexico City, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5084-9326","authenticated-orcid":true,"given":"Se Hoon","family":"Park","sequence":"additional","affiliation":[{"name":"Division of Hematology-Oncology, Departement of Medicine, Samsung Medical Center, Sungkyunkwan University, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3358-4466","authenticated-orcid":true,"given":"Patrizia","family":"Giannatempo","sequence":"additional","affiliation":[{"name":"Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3479-4203","authenticated-orcid":false,"given":"Zin War","family":"Myint","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology, Department of Internal Medicine, Markey Cancer Center, University of Kentucky, Lexington, KY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0316-9621","authenticated-orcid":true,"given":"Thomas","family":"B\u00fcttner","sequence":"additional","affiliation":[{"name":"Department of Urology, University Hospital Bonn, Bonn, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0134-4732","authenticated-orcid":true,"given":"Enrique","family":"Grande","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, MD Anderson Cancer Center Madrid, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4096-7385","authenticated-orcid":true,"given":"Ondrej","family":"Fiala","sequence":"additional","affiliation":[{"name":"Department of Oncology and Radiotherapeutics, Faculty of Medicine, University Hospital and Charles University, Pilsen, Czech Republic"},{"name":"Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniele","family":"Santini","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences and Biotechnology, Policlinico Umberto I, University of Rome, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aristotelis","family":"Bamias","sequence":"additional","affiliation":[{"name":"2nd Propaedeutic Department of Internal Medicine, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8301-8879","authenticated-orcid":true,"given":"Roubini","family":"Zakopoulou","sequence":"additional","affiliation":[{"name":"2nd Propaedeutic Department of Internal Medicine, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0876-0226","authenticated-orcid":true,"given":"Sebastiano","family":"Buti","sequence":"additional","affiliation":[{"name":"Medical Oncology Unit, University Hospital of Parma, Parma, Italy"},{"name":"Department of Medicine and Surgery, University of Parma, Parma, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2351-881X","authenticated-orcid":true,"given":"Ravindran","family":"Kanesvaran","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4668-4765","authenticated-orcid":true,"given":"Pasquale","family":"Rescigno","sequence":"additional","affiliation":[{"name":"Centre for Cancer, Translational and Clinical Research Institute, Newcastle University, Newcastle Upon Tyne, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4616-0598","authenticated-orcid":true,"given":"Javier","family":"Molina-Cerrillo","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Hospital Ram\u00f3n y Cajal, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-1085-7817","authenticated-orcid":true,"given":"Ilana","family":"Epstein","sequence":"additional","affiliation":[{"name":"Lank Center for Genitourinary Oncology, Dana Farber Cancer Institute, Boston, MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6621-8251","authenticated-orcid":true,"given":"Fernando Sabino","family":"Marques Monteiro","sequence":"additional","affiliation":[{"name":"Latin American Cooperative Oncology Group (LACOG), Porto Alegre, Brazil"},{"name":"Department of Oncology and Hematology, Hospital S\u00edrio-Liban\u00eas, Bras\u00edlia, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Massari","sequence":"additional","affiliation":[{"name":"Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy"},{"name":"Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Camillo","family":"Porta","sequence":"additional","affiliation":[{"name":"Medical Oncology Unit, Azienda Ospedaliera Universitaria Consorziale Policlinico di Bari, Bari, Italy"},{"name":"Interdisciplinary Department of Medicine, University of Bari \u201cAldo Moro\u201d, Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2328-3421","authenticated-orcid":true,"given":"Joaquin","family":"Bellmunt","sequence":"additional","affiliation":[{"name":"Lank Center for Genitourinary Oncology, Dana Farber Cancer Institute, Boston, MA"},{"name":"Harvard Medical School, Boston, MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matteo","family":"Santoni","sequence":"additional","affiliation":[{"name":"Oncology Unit, Macerata Hospital, Macerata, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"233","reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.7189\/jogh.13.04109"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2023.03.029"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clgc.2022.10.002"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1613683"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdz127"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2035807"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.annonc.2023.08.016"},{"key":"e_1_3_5_9_2","first-page":"E412","article-title":"Regional differences in metastatic urothelial carcinoma of the urinary bladder patients across the United States SEER registries","volume":"17","author":"Garcia CC","year":"2023","unstructured":"Garcia CC, Tappero S, Piccinelli ML, et al: Regional differences in metastatic urothelial carcinoma of the urinary bladder patients across the United States SEER registries. Can Urol Assoc J 17:E412-E419, 2023","journal-title":"Can Urol Assoc J"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00262-023-03469-5"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00262-023-03518-z"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10238-023-01235-6"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00262-024-03682-w"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10585-024-10296-0"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11523-024-01089-2"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-70182-3"},{"key":"e_1_3_5_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2008.10.026"},{"key":"e_1_3_5_18_2","unstructured":"A healthy lifestyle\u2014WHO recommendations. https:\/\/www.who.int\/europe\/news-room\/fact-sheets\/item\/a-healthy-lifestyle---who-recommendations"},{"key":"e_1_3_5_19_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2016.0843"},{"key":"e_1_3_5_20_2","doi-asserted-by":"publisher","DOI":"10.1111\/bju.15984"},{"key":"e_1_3_5_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(08)70032-9"},{"key":"e_1_3_5_22_2","doi-asserted-by":"publisher","DOI":"10.1097\/PPO.0b013e3181ff2aec"},{"key":"e_1_3_5_23_2","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.4917"},{"key":"e_1_3_5_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.urolonc.2021.09.022"},{"key":"e_1_3_5_25_2","doi-asserted-by":"publisher","DOI":"10.1590\/1806-9282.20231116"},{"key":"e_1_3_5_26_2","doi-asserted-by":"publisher","DOI":"10.21037\/tau-24-165"},{"key":"e_1_3_5_27_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00432-022-03926-1"},{"key":"e_1_3_5_28_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.24.00340"},{"key":"e_1_3_5_29_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2408154"},{"key":"e_1_3_5_30_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.9417"},{"key":"e_1_3_5_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clgc.2023.09.010"},{"key":"e_1_3_5_32_2","doi-asserted-by":"publisher","DOI":"10.3233\/BLC-211523"},{"key":"e_1_3_5_33_2","doi-asserted-by":"publisher","DOI":"10.14740\/jocmr4162"},{"key":"e_1_3_5_34_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.34057"},{"key":"e_1_3_5_35_2","doi-asserted-by":"publisher","DOI":"10.1111\/iju.15300"},{"key":"e_1_3_5_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2024.114235"},{"key":"e_1_3_5_37_2","doi-asserted-by":"publisher","DOI":"10.1080\/14737140.2020.1813029"},{"key":"e_1_3_5_38_2","article-title":"Latin American consensus for the evaluation and treatment of patients with metastatic\/locally advanced urothelial carcinoma","author":"Manneh Kopp R","unstructured":"Manneh Kopp R, Galanternik F, Schutz FA, et al: Latin American consensus for the evaluation and treatment of patients with metastatic\/locally advanced urothelial carcinoma. JCO Glob Oncol 10.1200\/GO.23.00244","journal-title":"JCO Glob Oncol"}],"container-title":["JCO Global Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ascopubs.org\/doi\/pdfdirect\/10.1200\/GO-24-00564","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,8]],"date-time":"2025-07-08T15:59:10Z","timestamp":1751990350000},"score":1,"resource":{"primary":{"URL":"https:\/\/ascopubs.org\/doi\/10.1200\/GO-24-00564"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7]]},"references-count":37,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,7]]}},"alternative-id":["10.1200\/GO-24-00564"],"URL":"https:\/\/doi.org\/10.1200\/go-24-00564","relation":{},"ISSN":["2687-8941"],"issn-type":[{"value":"2687-8941","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7]]},"assertion":[{"value":"2024-11-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-15","order":1,"name":"revised","label":"Revised","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-04-14","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-08","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e2400564"}}