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Background: Phase II trials showed the efficacy of anti-HER2 RC48-ADC (disitamab vedotin) for HER2-positive metastatic urothelial carcinoma (UC). This study evaluated RC48 alone verses in combination with immunotherapy for locally advanced or metastatic UC using real-world data.
Methods: This retrospective, multicenter, real-world study included patients with locally advanced or metastatic UC who received RC48 in five hospitals in China between July 2021 and April 2022. The outcomes were progression-free survival (PFS), overall survival (OS), objective response rate (ORR), disease control rate (DCR), and adverse events.
Results: Thirty-six patients were included. The patients were 47-87 years, and 26 (72.2%) were male. Eighteen patients received RC48 alone, and 18 received RC48 combined with a programmed death-1 antibody. The median PFS was 5.4 months. The median OS was not reached. The 6-month and 1-year PFS rates were 38.8% and 15.5%, respectively. The 1-year OS rate was 79.6%. Fourteen (38.9%) patients achieved a partial response, and the ORR was 38.9%. Eleven patients had stable disease, and the DCR was 69.4%. The median PFS for patients who received RC48 combined with immunotherapy and those who received RC48 alone was 8.5 and 5.4 months, respectively. The main treatment-related adverse events included anemia, hypoesthesia, fatigue, and elevated transaminase. No treatment-related death occurred.
Conclusion: RC48 alone or combined with immunotherapy might benefit patients with locally advanced or metastatic UC, regardless of impaired renal function.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10264489 | PMC |
http://dx.doi.org/10.1007/s00262-023-03419-1 | DOI Listing |
Neoplasia
October 2025
State Key Laboratory of Systems Medicine for Cancer, Department of Urology, Shanghai Cancer Institute, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. Electronic address:
Purpose: Although trimodal therapy is currently the standard organ-sparing approach for muscle-invasive bladder cancer (MIBC), its clinical benefit is limited, and noninvasive biomarkers to guide dynamic decision-making are lacking. Here, we present a proof-of-concept study evaluating disitamab vedotin (RC48, a HER2-targeted antibody-drug conjugate) combined with toripalimab (JS001, anti-PD-1) and radiotherapy for bladder preservation in localized HER2-positive MIBC.
Patients And Methods: In the first-stage of an open-label phase II clinical trial (ClinicalTrials.
HER2 expression is correlated with diminished efficacy of Bacillus Calmette-Guérin (BCG) instillation in high-risk non-muscle-invasive bladder cancer (HR-NMIBC). The development of effective intravesical treatments for HER2-expressing HR-NMIBC is of great urgency. In this single-arm phase I trial (ChiCTR2300073975), HER2-expressing HR-NMIBC patients received an induction course of weekly intravesical Disitamab vedotin (RC48) following a 3+3 design (60, 120, or 180 mg) for 6 weeks, followed by optional maintenance dose monthly for 11 sessions.
View Article and Find Full Text PDFIn this study, 102 cisplatin-ineligible patients with muscle-invasive bladder cancer (MIBC) who received neoadjuvant RC48-ADC combined with immunotherapy were included. We evaluated the pathological responses and explored multiple clinical characteristics to identify independent predictive indicators of the efficacy. The results showed that neoadjuvant RC48-ADC combined with immunotherapy had promising efficacy.
View Article and Find Full Text PDFInt Urol Nephrol
May 2025
Department of Urology, Gansu Province Clinical Research Center for urinary system disease, The Second Hospital & Clinical Medical School, Lanzhou University, Lanzhou, China.
Objectives: This study aimed to evaluate the efficacy and safety of RC48-ADC combined with PD-1 inhibitors in bladder preservation therapy for muscle-invasive bladder cancer (MIBC), and to explore the differences in treatment outcomes between primary and recurrent cases, as well as patients at different clinical stages.
Methods: A retrospective analysis was conducted on 32 patients with clinically non-metastatic MIBC who received ≥ 3 cycles of RC48-ADC combined with PD-1 inhibitor therapy. Clinical efficacy was assessed through integrated imaging and histopathological evaluations.
BMC Cancer
April 2025
Department of Medical Oncology, Sun Yat-sen University Cancer Certer, Guangzhou, China.
Background: Approximately half of urothelial carcinoma (UC) patients exhibit low or null HER2 expression. Limited data are available on the efficacy of anti-HER2 RC48-ADC (Disitamab Vedotin) in HER2 low and null advanced UC.
Methods: Patients with locally advanced or metastatic UC (la/mUC) with HER2 low (IHC 1+) and null (IHC 0) expression who received RC48-ADC monotherapy or in combination with programmed cell death protein 1 (PD-1) inhibitors were enrolled in this multi-center, retrospective study.