Clinical Efficacy and Safety Analysis of Toripalimab Combined with GC Chemotherapy for Advanced Urothelial Carcinoma

Objective: To analyze the clinical efficacy and safety of toripalimab combined with the GC chemotherapy regimen in the treatment of advanced urothelial carcinoma. Methods: A retrospective study was conducted on 102 patients with advanced urothelial carcinoma treated at our hospital between March 2021 and August 2024. Based on treatment regimens, patients were divided into a chemotherapy group (n = 52) and a combination group (n = 50). The chemotherapy group received the GC chemotherapy regimen, while the combination group received GC chemotherapy combined with toripalimab. Both groups underwent 4–6 cycles of treatment based on patient tolerance. Clinical efficacy, immune-related factor levels, survival outcomes, and safety were observed and compared. Results: The disease control rate (DCR) and overall response rate (ORR) in the combination group were slightly higher than those in the chemotherapy group, but the differences were not statistically significant (P > 0.05). After treatment, levels of IFN-γ and IL-2 increased significantly, while VEGF levels decreased significantly in both groups (P < 0.05), with superior outcomes observed in the combination group (P < 0.05). Follow-up analysis showed progression-free survival (PFS) and median overall survival (OS) in the chemotherapy group were 5.19 and 10.15 months, respectively, compared to 8.24 and 18.23 months in the combination group, with statistically significant differences (P < 0.05). During treatment, the incidence of adverse reactions such as rash, immune-related pneumonia, and immune-related diarrhea was higher in the combination group than in the chemotherapy group (P < 0.05). However, the incidence of gastrointestinal reactions, fever, and leukopenia did not differ significantly between the two groups (P > 0.05). Conclusion: The use of toripalimab combined with the GC chemotherapy regimen for advanced urothelial carcinoma can effectively improve clinical outcomes and extend patient survival, with good overall safety. However, attention should be given to preventing adverse reactions such as rash and pneumonia during treatment.