PMID- 34078134 OWN - NLM STAT- MEDLINE DCOM- 20220201 LR - 20220201 IS - 1750-7448 (Electronic) IS - 1750-743X (Linking) VI - 13 IP - 11 DP - 2021 Aug TI - Adverse events of the second-line treatment for patients with locally advanced or metastatic urothelial carcinoma of the bladder: network meta-analysis. PG - 917-929 LID - 10.2217/imt-2020-0305 [doi] AB - Aim: We aimed to compare the mortality rates related to adverse events (AEs) and discontinuation of treatment due to toxicity as well as all AEs of currently used regimens of second-line treatment strategies for advanced or metastatic urothelial carcinoma of the bladder. Methods: The MEDLINE and EMBASE databases were searched for articles according to the PRISMA extension statement for network meta-analysis. Results: Five trials comprising 2205 patients met our eligibility criteria. It is highly likely that immunotherapy, as single regimen, has the lowest rates of motor and sensory neuropathies, constipation, abdominal pain, alopecia, decreased appetite, vomiting and febrile neutropenia. Immunotherapy, in combination regimen, has the lowest rates of anemia and fatigue. Conclusion: Immunotherapy, especially as single regimen, demonstrated the highest favorable tolerability to most AEs. FAU - Laukhtina, Ekaterina AU - Laukhtina E AUID- ORCID: 0000-0002-8953-0272 AD - Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, 1090, Austria. AD - Institute for Urology & Reproductive Health, Sechenov University, Moscow, 119991, Russia. FAU - Mori, Keiichiro AU - Mori K AUID- ORCID: 0000-0002-6147-6569 AD - Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, 1090, Austria. AD - Department of Urology, The Jikei University School of Medicine, Tokyo, Japan. FAU - Mostafaei, Hadi AU - Mostafaei H AUID- ORCID: 0000-0001-5596-1771 AD - Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, 1090, Austria. AD - Research Center for Evidence Based Medicine, Tabriz University of Medical Sciences, Tabriz , 5166, Iran. FAU - Merseburger, Axel S AU - Merseburger AS AUID- ORCID: 0000-0001-6467-3931 AD - Department of Urology, Campus Lubeck, University Hospital Schleswig-Holstein, Lubeck , 23562, Germany. FAU - Nyirady, Peter AU - Nyirady P AUID- ORCID: 0000-0002-7037-4919 AD - Department of Urology, Semmelweis University, Budapest, 1082, Hungary. FAU - Moschini, Marco AU - Moschini M AUID- ORCID: 0000-0002-3084-2458 AD - Department of Urology, Luzerner Kantonsspital, Lucerne , 6000, Switzerland. AD - Department of Urology & Division of Experimental Oncology, Urological Research Institute, Vita-Salute San Raffaele, Milan , 20132, Italy. FAU - Quhal, Fahad AU - Quhal F AUID- ORCID: 0000-0002-8163-6953 AD - Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, 1090, Austria. AD - Department of Urology, King Fahad Specialist Hospital, Dammam , 32253, Saudi Arabia. FAU - Schuettfort, Victor M AU - Schuettfort VM AUID- ORCID: 0000-0002-7114-0508 AD - Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, 1090, Austria. AD - Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, 20251, Germany. FAU - Pradere, Benjamin AU - Pradere B AUID- ORCID: 0000-0002-7768-8558 AD - Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, 1090, Austria. FAU - Motlagh, Reza Sari AU - Motlagh RS AUID- ORCID: 0000-0002-3819-9911 AD - Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, 1090, Austria. FAU - Enikeev, Dmitry AU - Enikeev D AUID- ORCID: 0000-0001-7169-2209 AD - Institute for Urology & Reproductive Health, Sechenov University, Moscow, 119991, Russia. FAU - Shariat, Shahrokh F AU - Shariat SF AUID- ORCID: 0000-0002-6627-6179 AD - Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, 1090, Austria. AD - Institute for Urology & Reproductive Health, Sechenov University, Moscow, 119991, Russia. AD - Department of Urology, Weill Cornell Medical College, New York, NY 14853, USA. AD - Department of Urology, University of Texas Southwestern, Dallas, TX 75390, USA. AD - Department of Urology, Second Faculty of Medicine, Charles University, Prague , 15006, Czech Republic. AD - Karl Landsteiner Institute of Urology & Andrology, Vienna , 1010, Austria. AD - Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman , 11942, Jordan. FAU - Of Urology-Young Academic Urologists Eau-Yau Urothelial Carcinoma Working Group, European Association AU - Of Urology-Young Academic Urologists Eau-Yau Urothelial Carcinoma Working Group EA LA - eng PT - Journal Article PT - Meta-Analysis PT - Research Support, Non-U.S. Gov't PT - Systematic Review DEP - 20210603 PL - England TA - Immunotherapy JT - Immunotherapy JID - 101485158 RN - 0 (Antineoplastic Agents, Immunological) SB - IM MH - Antineoplastic Agents, Immunological/*therapeutic use MH - Carcinoma, Transitional Cell/*drug therapy MH - Humans MH - Immunotherapy/*adverse effects/methods MH - Network Meta-Analysis MH - Salvage Therapy/*methods MH - Urinary Bladder Neoplasms/*drug therapy OAB - Lay abstract In the era of precision medicine, the challenge is to identify the patients who are most likely to benefit from different treatment strategies. We believe that findings of the present network meta-analysis may facilitate individualized treatment strategies based on adverse events to guide regarding the potentially best tolerated approach for patients with urothelial carcinoma of the bladder. Immunotherapy, especially as single regimen, demonstrated the highest favorable tolerability to most adverse events. OABL- eng OTO - NOTNLM OT - RCT OT - UC OT - UCB OT - adverse events OT - chemotherapy OT - immunotherapy OT - network meta-analyses OT - second-line EDAT- 2021/06/04 06:00 MHDA- 2022/02/02 06:00 CRDT- 2021/06/03 05:29 PHST- 2021/06/04 06:00 [pubmed] PHST- 2022/02/02 06:00 [medline] PHST- 2021/06/03 05:29 [entrez] AID - 10.2217/imt-2020-0305 [doi] PST - ppublish SO - Immunotherapy. 2021 Aug;13(11):917-929. doi: 10.2217/imt-2020-0305. Epub 2021 Jun 3.