Impact of the objective response to and number of cycles of platinum-based first-line chemotherapy for metastatic urothelial carcinoma on overall survival of patients treated with pembrolizumab

被引：21

作者：

Kato, Minoru ^{[1
]}

Kobayashi, Takashi ^{[2
]}

Matsui, Yoshiyuki ^{[3
]}

Ito, Katsuhiro ^{[4
]}

Hikami, Kensuke ^{[5
]}

Yamada, Takeshi ^{[6
]}

Ogawa, Kosuke ^{[7
]}

Nakamura, Kenji ^{[8
]}

Sassa, Naoto ^{[9
]}

Yokomizo, Akira ^{[10
]}

Abe, Takashige ^{[11
]}

Tsuchihashi, Kazunari ^{[12
]}

Tatarano, Shuichi ^{[13
]}

Inokuchi, Junichi ^{[14
]}

Tomida, Ryotaro ^{[15
]}

Fujiwara, Maki ^{[16
]}

Takahashi, Atsushi ^{[17
]}

Matsumoto, Kazumasa ^{[18
]}

Shimizu, Kosuke ^{[19
]}

Araki, Hiromasa ^{[20
]}

Kurahashi, Ryoma ^{[21
]}

Ozaki, Yu ^{[22
]}

Tashiro, Yu ^{[23
]}

Uegaki, Masayuki ^{[24
]}

Kojima, Takahiro ^{[25
]}

Uchida, Junji ^{[1
]}

Ogawa, Osamu ^{[2
]}

Nishiyama, Hiroyuki ^{[25
]}

Kitamura, Hiroshi ^{[26
]}

机构：

[1] Osaka City Univ, Dept Urol, Osaka, Japan

[2] Kyoto Univ, Dept Urol, Grad Sch Med, Kyoto, Japan

[3] Natl Canc Ctr, Dept Urol, Tokyo, Japan

[4] Ijinkai Takeda Gen Hosp, Dept Urol, Kyoto, Japan

[5] Japanese Red Cross Wakayama Med Ctr, Dept Urol, Wakayama, Japan

[6] Kyoto Prefectural Univ Med, Dept Urol, Kyoto, Japan

[7] Kobe City Nishi Kobe Med Ctr, Dept Urol, Kobe, Hyogo, Japan

[8] Japanese Red Cross Osaka Hosp, Dept Urol, Osaka, Japan

[9] Aichi Med Univ Hosp, Dept Urol, Nagakute, Aichi, Japan

[10] Harasanshin Hosp, Dept Urol, Fukuoka, Japan

[11] Hokkaido Univ, Dept Urol, Sapporo, Hokkaido, Japan

[12] Japanese Red Cross Otsu Hosp, Dept Urol, Otsu, Shiga, Japan

[13] Kagoshima Univ, Dept Urol, Kagoshima, Japan

[14] Kyushu Univ, Dept Urol, Fukuoka, Japan

[15] Shikoku Canc Ctr, Dept Urol, Matsuyama, Ehime, Japan

[16] Tenri Hosp, Dept Urol, Tenri, Nara, Japan

[17] Hakodate Goryoukaku Hosp, Dept Urol, Hakodate, Hokkaido, Japan

[18] Kitasato Univ, Dept Urol, Sagamihara, Kanagawa, Japan

[19] Kyoto Katsura Hosp, Dept Urol, Kyoto, Japan

[20] Natl Hosp Org Kyoto Med Ctr, Dept Urol, Kyoto, Japan

[21] Kumamoto Univ, Dept Urol, Kumamoto, Japan

[22] Natl Hosp Org Himeji Med Ctr, Dept Urol, Himeji, Hyogo, Japan

[23] Kitano Hosp, Dept Urol, Tazuke Kofukai Med Res Inst, Osaka, Japan

[24] Toyooka Hosp, Dept Urol, Toyooka, Japan

[25] Univ Tsukuba, Dept Urol, Tsukuba, Ibaraki, Japan

[26] Univ Toyama, Dept Urol, Toyama, Japan

来源：

INTERNATIONAL JOURNAL OF UROLOGY | 2021年 / 28卷 / 12期

关键词：

biomarkers; chemotherapy; pembrolizumab; survival; urothelial cancer; CISPLATIN-INELIGIBLE PATIENTS; SINGLE-ARM; PROGNOSTIC-FACTORS; MULTICENTER; CANCER; THERAPY; TRIAL; ATEZOLIZUMAB; GEMCITABINE;

D O I：

10.1111/iju.14686

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

Objectives To investigate the impact of the number of cycles and objective response to chemotherapy on overall survival in patients with metastatic urothelial carcinoma treated with pembrolizumab. Methods This multicenter, retrospective study included 755 patients from 59 institutions with advanced, chemoresistant urothelial carcinoma who received pembrolizumab. The associations of the overall survival with the number of cycles and best objective response were investigated using Cox multiple regression analysis. Results Overall, 391 patients received standard first-line chemotherapy and pembrolizumab as a second-line treatment, and were included in the final analysis. Of the 391 patients, 185 received less than four cycles, 134 received four to six cycles and 72 received more than six cycles of first-line chemotherapy. An objective response (complete or partial response) to chemotherapy was observed in 145 patients (37.1%). Univariate analysis showed that the overall survival of patients who received more than six cycles or responded to chemotherapy (complete or partial response) was significantly longer than that of patients who received less than four cycles or did not respond to chemotherapy (stable or progressive disease). At multivariate levels, no correlations were observed between overall survival and the number of cycles of or the response to chemotherapy. Conclusions Therapeutic benefit of pembrolizumab can be expected irrespective of the objective response to and number of cycles of platinum-based first-line chemotherapy.

引用

页码：1261 / 1267

页数：7

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