Journal article
Association between prior radical surgery (RS) and outcomes with immune checkpoint inhibitor (ICI) therapy for advanced urothelial carcinoma (aUC)
Journal of clinical oncology, Vol.39(6_suppl), pp.444-444
02/20/2021
DOI: 10.1200/JCO.2021.39.6_suppl.444
Abstract
Abstract only
444
Background: It is unclear whether prior RS of primary tumor is associated with response and outcomes with ICI in aUC. We hypothesized that such response and outcomes would not differ based on prior RS. Methods: We performed a retrospective cohort study including patients (pts) with aUC who received ICI. We compared overall response rate (ORR), progression-free survival (PFS), and overall survival (OS) between pts with vs without RS [cystectomy or (nephro)-ureterectomy]. Analysis was stratified based on ICI therapy line (first-line vs salvage). A separate comparison between pts with prior RS or radiation (RT) only or none was also pursued. ORR was compared between groups using logistic regression, as well OS and PFS using cox regression analysis; a multivariable model was built adjusting for calculated Bellmunt score. P<0.05 was significant. Results: We identified 984 pts from 24 institutions; 682, 704 and 673 were included in OS, PFS and ORR analyses, respectively; 54% of pts had prior RS with median age 68 at ICI initiation with RS vs 71 without RS with similar proportion of men (73-74%) and ever smokers (70-71%). The RS group had higher proportion (%) of white pts (77% vs 71%), lower % of pts with Hb<10g/dL at ICI initiation (23% vs 32%) but not significantly higher % of liver metastasis at ICI initiation (23% vs 17%). Bellmunt score with vs without RS was 16% vs 11%, 50% vs 48%, 27% vs 37%, 7% vs 4% for 0, 1, 2, and 3, respectively. ORR and PFS were not significantly different between groups, while prior RS was associated with longer OS (unadjusted HR 0.8, p=0.03). However, after adjustment for Bellmunt score, this association was not significant (table). Upon stratification based on treatment line, OS was longer with prior RS (0.7, p=0.03) for those treated with salvage ICI but this was not significant after adjusting for Bellmunt score. ORR, PFS and OS were not significantly different between pts receiving prior RT only vs RS vs none. Conclusions: Prior RS was not significantly associated with longer OS in pts with aUC receiving ICI after adjusting for Bellmunt score. Further work is needed to interrogate tumor-host immune interactions and identify biomarkers that can be prognostic and/or predictive of ICI response. [Table: see text]
Details
- Title: Subtitle
- Association between prior radical surgery (RS) and outcomes with immune checkpoint inhibitor (ICI) therapy for advanced urothelial carcinoma (aUC)
- Creators
- Dimitrios Makrakis - University of WashingtonDaniel Castellano - Research Institute Hospital 12 de OctubreIvan de Kouchkovsky - University of California, San FranciscoJoseph J. Park - University of Michigan–Ann ArborMehmet Asim Bilen - Emory UniversityNeeraj Agarwal - University of UtahYousef Zakharia - University of IowaRafael Morales-Barrera - Vall d’Hebron Institute of Oncology, Barcelona, SpainMichael E. Devitt - University of VirginiaAriel Ann Nelson - Medical College of WisconsinBenjamin A. Gartrell - Albert Einstein College of MedicineAbhishek Tripathi - University of Oklahoma Health Sciences CenterAristotelis Bamias - National and Kapodistrian University of AthensAlejo Rodriguez-Vida - Hospital Del MarSandy Liu - University of California, Los AngelesRana R. McKay - University of San DiegoLucia Andrea Alonso Buznego - Marqués de Valdecilla University HospitalJure Murgic - Princess Margaret Cancer CentrePetros Grivas - University of WashingtonAli Raza Khaki - University of Washington
- Resource Type
- Journal article
- Publication Details
- Journal of clinical oncology, Vol.39(6_suppl), pp.444-444
- DOI
- 10.1200/JCO.2021.39.6_suppl.444
- ISSN
- 0732-183X
- eISSN
- 1527-7755
- Grant note
- name: None
- Language
- English
- Date published
- 02/20/2021
- Academic Unit
- Hematology, Oncology, and Blood & Marrow Transplantation; Internal Medicine
- Record Identifier
- 9984548263302771
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