Abstract:
BACKGROUND:First-line PD-inhibition in cisplatin-ineligible patients with locally advanced or metastatic urothelial cancer represents a novel clinical setting, with uncertainty concerning second-line outcomes. Specifying second-line treatment and outcomes will provide guidance in this new sequence. We performed a retrospective chart review to document the outcomes of these patients treated at our institution. PATIENTS AND METHODS:Our cohort consisted of 43 patients with advanced urothelial cancer receiving first-line checkpoint inhibition. Baseline factors, programmed death-ligand 1 (PD-L1) status, treatments, and outcomes during and beyond the first line were obtained. Response was scored using Response Evaluation Criteria in Solid Tumors, version 1.1 criteria. Log rank tests were used to compare outcomes in prognostic subgroups, and outcome associations with PD-L1 status were analyzed with Fisher exact tests. RESULTS:A total of 43 patients received first-line atezolizumab or pembrolizumab from June 2014 until June 2018. The median age was 76.8 years, and the population was 74% male, with 60% having visceral metastases. Reasons for cisplatin ineligibility were Eastern Cooperative Oncology Group performance status 2%, 30%; renal insufficiency, 44%, and both, 21%. First-line objective response rate (ORR) was 30%, and complete response was 14%. The median overall survival was 11.7 months. Of 29 patients progressing, 17 received second-line treatment (most commonly, gemcitabine/carboplatin [10 patients]). The second-line response rate was 33%, and the ORR was 11%. The second-line median overall survival was 6.2 months. No association was found between PD-L1 status and outcomes. CONCLUSION:Outcomes with first-line immunotherapy are consistent with historical outcomes. The ORR after first-line checkpoint inhibition falls short of historical comparators; however, the response rate compares favorably to those of chemotherapies used in previous second-line regimens. The older age and poorer performance status may have contributed to second-line outcomes.
journal_name
Clin Genitourin Cancerjournal_title
Clinical genitourinary cancerauthors
Hsu MM,Xia Y,Troxel A,Delbeau D,Francese K,Leis D,Shepherd D,Balar AVdoi
10.1016/j.clgc.2019.10.001subject
Has Abstractpub_date
2020-06-01 00:00:00pages
e209-e216issue
3eissn
1558-7673issn
1938-0682pii
S1558-7673(19)30305-2journal_volume
18pub_type
杂志文章abstract::The spontaneous intraperitoneal rupture of the urinary bladder is an extremely rare and life-threatening event. Often, there are difficulties in establishing the diagnosis. A patient with spontaneous perforation of the urinary bladder, 17 years after successful treatment of an adenocarcinoma of the prostate by pelvic ...
journal_title:Clinical genitourinary cancer
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doi:10.3816/CGC.2007.n.006
更新日期:2007-03-01 00:00:00
abstract:BACKGROUND:Limited information is available about the effect of bleomycin administration on the development of pulmonary toxicity in metastatic germ cell tumors (GCT). PATIENTS AND METHODS:A literature search was conducted to identify randomized trials of first-line chemotherapy for GCT. We conducted univariate and mu...
journal_title:Clinical genitourinary cancer
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journal_title:Clinical genitourinary cancer
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journal_title:Clinical genitourinary cancer
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journal_title:Clinical genitourinary cancer
pub_type: 杂志文章,多中心研究
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journal_title:Clinical genitourinary cancer
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journal_title:Clinical genitourinary cancer
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journal_title:Clinical genitourinary cancer
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journal_title:Clinical genitourinary cancer
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journal_title:Clinical genitourinary cancer
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doi:10.1016/j.clgc.2013.11.001
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journal_title:Clinical genitourinary cancer
pub_type: 杂志文章,meta分析
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更新日期:2019-12-01 00:00:00
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journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.3816/CGC.2009.n.035
更新日期:2009-10-01 00:00:00
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journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.3816/CGC.2007.n.036
更新日期:2007-12-01 00:00:00
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journal_title:Clinical genitourinary cancer
pub_type: 杂志文章,评审
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更新日期:2016-10-01 00:00:00
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journal_title:Clinical genitourinary cancer
pub_type: 杂志文章,评审
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更新日期:2019-02-01 00:00:00
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journal_title:Clinical genitourinary cancer
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doi:10.3816/CGC.2007.n.012
更新日期:2007-06-01 00:00:00
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journal_title:Clinical genitourinary cancer
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journal_title:Clinical genitourinary cancer
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journal_title:Clinical genitourinary cancer
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journal_title:Clinical genitourinary cancer
pub_type: 杂志文章,多中心研究
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journal_title:Clinical genitourinary cancer
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更新日期:2019-10-01 00:00:00
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journal_title:Clinical genitourinary cancer
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更新日期:2017-06-01 00:00:00
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journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2015.12.029
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pub_type: 临床试验,杂志文章
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journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
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