Journal article
Histological Subtypes and Response to PD-1/PD-L1 Blockade in Advanced Urothelial Cancer: A Retrospective Study
The Journal of urology, Vol.204(1), pp.63-69
07/01/2020
DOI: 10.1097/JU.0000000000000761
PMCID: PMC7289665
PMID: 31971495
Abstract
Purpose: Urinary tract cancer can be pure urothelial carcinoma, pure non-urothelial carcinoma or variant urothelial carcinoma (defined here as mixed urothelial carcinoma). Little is known regarding outcomes for patients with variant urothelial carcinoma receiving immune checkpoint inhibitors. We hypothesized that variant urothelial carcinoma does not compromise immune checkpoint inhibitor efficacy in patients with advanced urothelial carcinoma.
Materials and Methods: We performed a retrospective cohort study across 18 institutions. Demographic, clinicopathological, treatment and outcomes data were collected for patients with advanced urothelial carcinoma who received immune checkpoint inhibitors. Patients were divided into pure vs variant urothelial carcinoma subgroups, with variant urothelial carcinoma further divided by type of variant (ie squamous, neuroendocrine etc). We compared overall response rate using univariate and multivariate logistic regression and progression-free survival and overall survival using Kaplan-Meier and univariate and multivariate Cox proportional hazards.
Results: Overall 519 patients were identified, with 395, 406 and 403 included in overall response rate, overall survival and progression-free survival analyses, respectively. Overall response rate to immune checkpoint inhibitors between patients with pure vs variant urothelial carcinoma was comparable (28% vs 29%, p = 0.90) without significant differences for individual subtypes vs pure urothelial carcinoma. Median overall survival for patients with pure urothelial carcinoma was 11.0 months vs 10.1 months for variant urothelial carcinoma (p = 0.60), but only 4.6 months for patients with neuroendocrine features (9 patients, HR 2.75, 95% CI1.40-5.40 vs pure urothelial carcinoma, p = 0.003). Median progression-free survival was 4.1 months for pure vs 5.2 months for variant urothelial carcinoma (p = 0.43) and 3.7 months for neuroendocrine features (HR 1.87, 95% CI 0.92-3.79 vs pure urothelial carcinoma, p = 0.09).
Conclusions: Overall response rate to immune checkpoint inhibitors was comparable across histological types. However, overall survival was worse for patients with tumors containing neuroendocrine features. Variant urothelial carcinoma should not exclude patients from receiving immune checkpoint inhibitors.
Details
- Title: Subtitle
- Histological Subtypes and Response to PD-1/PD-L1 Blockade in Advanced Urothelial Cancer: A Retrospective Study
- Creators
- Natalie J. Miller - University of WashingtonAli Raza Khaki - University of WashingtonLeonidas N. Diamantopoulos - University of WashingtonMehmet A. Bilen - Emory UniversityVictor Santos - University of UtahNeeraj Agarwal - University of UtahRafael Morales-Barrera - Universitat Autònoma de BarcelonaMichael Devitt - University of VirginiaAriel Nelson - University Hospitals Cleveland Medical CenterChristopher J. Hoimes - University Hospitals Cleveland Medical CenterEvan Shreck - Montefiore Medical CenterHussein Assi - University of Oklahoma Health Sciences CenterBenjamin A. Gartrell - Montefiore Medical CenterAlex Sankin - Montefiore Medical CenterAlejo Rodriguez-Vida - Hebron UniversityMark Lythgoe - Imperial College LondonDavid J. Pinato - Imperial College LondonAlexandra Drakaki - University of California, Los AngelesMonika Joshi - Penn State Milton S. Hershey Medical CenterPedro Isaacsson Velho - Sidney Kimmel Comprehensive Cancer CenterNoah Hahn - Sidney Kimmel Comprehensive Cancer CenterSandy Liu - University of California, Los AngelesLucia Alonso Buznego - Instituto de Investigación Marqués de ValdecillaIgnacio Duran - Instituto de Investigación Marqués de ValdecillaMarcus Moses - Tulane UniversityJayanshu Jain - University of IowaJure Murgic - Sisters of Charity HospitalPedro Barata - Tulane UniversityAbhishek Tripathi - University of Oklahoma Health Sciences CenterYousef Zakharia - University of IowaMatthew D. Galsky - Icahn School of Medicine at Mount SinaiGuru Sonpavde - Dana-Farber Cancer InstituteEvan Y. Yu - University of WashingtonGary H. Lyman - University of WashingtonPetros Grivas - University of Washington
- Resource Type
- Journal article
- Publication Details
- The Journal of urology, Vol.204(1), pp.63-69
- DOI
- 10.1097/JU.0000000000000761
- PMID
- 31971495
- PMCID
- PMC7289665
- NLM abbreviation
- J Urol
- ISSN
- 0022-5347
- eISSN
- 1527-3792
- Publisher
- Lippincott Williams & Wilkins
- Number of pages
- 7
- Grant note
- T32CA009515 / National Cancer Institute training grant; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Cancer Institute (NCI)
- Language
- English
- Date published
- 07/01/2020
- Academic Unit
- Hematology, Oncology, and Blood & Marrow Transplantation; Internal Medicine
- Record Identifier
- 9984548265202771
Metrics
6 Record Views