Supplemental Material for: Efficacy of adjuvant nivolumab versus adjuvant gemcitabine plus cisplatin/carboplatin after radical nephroureterectomy for upper tract urothelial carcinoma: a real-world analysis using a Japanese large-scale claims database

Using the Medical Data Vision database, we identified UTUC patients who underwent RNU and received adjuvant therapy. The adjuvant GC/GCarbo group and the adjuvant nivolumab group were defined by distinct treatment eras to reduce treatment selection bias. Event-free survival (EFS) was compared using Kaplan-Meier curves and the log-rank test, with a sensitivity analysis truncating follow-up at 300 days.</p><p dir="ltr">Results: A total of 1,058 patients were analyzed (240 nivolumab, 818 GC/GCarbo).

In the whole cohort, EFS was significantly longer in the nivolumab group (HR = 0.6365, P = 0.0076). This association was consistent in patients with neoadjuvant chemotherapy (HR = 0.4053, P = 0.001) and in those without it (HR = 0.6765, P = 0.0462).</p><p dir="ltr">Conclusion: In Japanese UTUC patients, adjuvant nivolumab was associated with a longer event-free survival than GC/GCarbo. Because this was an unadjusted, observational comparison, the finding should be interpreted with caution and regarded as hypothesis-generating.</p>