Retrospective analysis of patients with locally advanced or metastatic urothelial carcinoma treated in Argentina (2018–2025): results from the GUIA 2 study in real-world clinical practice
TL;DR
This first multicentre RWE study of la/mUC in Argentina shows treatment patterns and outcomes comparable to international cohorts, and confirms the survival benefit of maintenance therapy and underscores the importance of regional data to optimise urothelial cancer care in Latin America.
Abstract
Purpose: Urothelial carcinoma (UC) is the most common histological subtype of bladder cancer and a major public health concern. Patients from Latin America are often underrepresented in pivotal clinical trials, highlighting the importance of regional real-world evidence (RWE). This study aimed to characterise the clinical profile, treatment patterns and survival outcomes of patients with locally advanced or metastatic UC (la/mUC) in Argentina. Methods: We conducted a retrospective multicentre study across 19 public and private institutions in Argentina. Eligible patients were ≥18 years with confirmed la/mUC diagnosis between January 2018 and March 2025. Demographic, clinical and therapeutic data were collected. Progression-free survival (PFS) and overall survival (OS) were estimated by Kaplan–Meier analysis, with subgroup comparisons by log-rank test. Multivariable analysis identified prognostic factors for OS. Results: A total of 421 patients were included; the median age was 70 years, 76.4% were male and 70.8% had a history of tobacco use. First-line systemic therapy was administered in 89.8% of cases, predominantly carboplatin–gemcitabine (40.1%) or cisplatin–gemcitabine (33.9%). Maintenance therapy was received by 37.8%, mainly avelumab. Median PFS for first-line therapy was 9 months, improving from 6.2 to 13.3 months with maintenance ( p < 0.001). Median OS was 11.1 months without maintenance versus 24.6 months with maintenance ( p < 0.001). Median OS for the entire cohort was 16 months. Visceral metastases and poor performance status independently predicted worse OS. Conclusion: This first multicentre RWE study of la/mUC in Argentina shows treatment patterns and outcomes comparable to international cohorts. Findings confirm the survival benefit of maintenance therapy and underscore the importance of regional data to optimise urothelial cancer care in Latin America.