Journal article
Immune checkpoint inhibitors in advanced upper and lower tract urothelial carcinoma: a comparison of outcomes
BJU international, Vol.128(2), pp.196-205
08/2021
DOI: 10.1111/bju.15324
PMID: 33556233
Abstract
Objectives To compare clinical outcomes between patients with locally advanced (unresectable) or metastatic urothelial carcinoma (aUC) in the upper and lower urinary tract receiving immune checkpoint inhibitors (ICIs).
Patients and Methods We performed a retrospective cohort study collecting clinicopathological, treatment, and outcome data for patients with aUC receiving ICIs from 2013 to 2020 across 24 institutions. We compared the objective response rate (ORR), overall survival (OS), and progression-free survival (PFS) between patients with upper and lower tract UC (UTUC, LTUC). Uni- and multivariable logistic and Cox regression were used to assess the effect of UTUC on ORR, OS, and PFS. Subgroup analyses were performed stratified based on histology (pure, mixed) and line of treatment (first line, subsequent line).
Results Out of a total of 746 eligible patients, 707, 717, and 738 were included in the ORR, OS, and PFS analyses, respectively. Our results did not contradict the hypothesis that patients with UTUC and LTUC had similar ORRs (24% vs 28%; adjusted odds ratio [aOR] 0.73, 95% confidence interval [CI] 0.43-1.24), OS (median 9.8 vs 9.6 months; adjusted hazard ratio [aHR] 0.93, 95% CI 0.73-1.19), and PFS (median 4.3 vs 4.1 months; aHR 1.01, 95% CI 0.81-1.27). Patients with mixed-histology UTUC had a significantly lower ORR and shorter PFS vs mixed-histology LTUC (aOR 0.20, 95% CI 0.05-0.91 and aHR 1.66, 95% CI 1.06-2.59), respectively).
Conclusion Overall, patients with UTUC and LTUC receiving ICIs have comparable treatment response and outcomes. Subgroup analyses based on histology showed that those with mixed-histology UTUC had a lower ORR and shorter PFS compared to mixed-histology LTUC. Further studies and evaluation of molecular biomarkers can help refine patient selection for immunotherapy.
Details
- Title: Subtitle
- Immune checkpoint inhibitors in advanced upper and lower tract urothelial carcinoma: a comparison of outcomes
- Creators
- Stepan M. Esagian - Democritus University of ThraceAli Raza Khaki - University of Washington Medical CenterLeonidas N. Diamantopoulos - University of PittsburghLucia Carril-Ajuria - Hospital Universitario 12 De OctubreDaniel Castellano - Hospital Universitario 12 De OctubreIvan De Kouchkovsky - University of California, San FranciscoJoseph J. Park - University of MichiganAjjai Alva - University of MichiganMehmet A. Bilen - Emory UniversityTyler F. Stewart - University of California San DiegoRana R. McKay - University of California San DiegoVictor S. Santos - University of UtahNeeraj Agarwal - University of UtahJayanshu Jain - University of IowaYousef Zakharia - University of IowaRafael Morales-Barrera - Universitat Autònoma de BarcelonaMichael E. Devitt - University of VirginiaAriel Nelson - Medical College of WisconsinChristopher J. Hoimes - Duke Medical CenterEvan Shreck - Montefiore Medical CenterBenjamin A. Gartrell - Montefiore Medical CenterAlex Sankin - Montefiore Medical CenterAbhishek Tripathi - University of Oklahoma Health Sciences CenterRoubini Zakopoulou - National and Kapodistrian University of AthensAristotelis Bamias - National and Kapodistrian University of AthensAlejo Rodriguez-Vida - Hosp del Mar, Med Oncol Dept, Res Inst, Barcelona, SpainAlexandra Drakaki - University of California, Los AngelesSandy Liu - University of California, Los AngelesVivek Kumar - Brigham and Women's HospitalMark P. Lythgoe - Imperial College LondonDavid J. Pinato - Imperial College LondonJure Murgic - Univ Hosp Ctr Sestre Milosrdnice, Dept Oncol & Nucl Med, Zagreb, CroatiaAna Frobe - Zagreb School of BusinessMonika Joshi - Penn State Milton S. Hershey Medical CenterPedro Isaacsson Velho - Sidney Kimmel Comprehens Canc Ctr, Dept Oncol, Baltimore, MD USANoah Hahn - Sidney Kimmel Comprehensive Cancer CenterLucia Alonso Buznego - Marqués de Valdecilla University HospitalIgnacio Duran - Instituto de Investigación Marqués de ValdecillaMarcus Moses - Tulane UniversityPedro Barata - Tulane UniversityMatthew D. Galsky - Icahn School of Medicine at Mount SinaiGuru Sonpavde - Dana-Farber Cancer InstituteEvan Y. Yu - University of Washington Medical CenterPavlos Msaouel - The University of Texas MD Anderson Cancer CenterVadim S. Koshkin - University of California, San FranciscoPetros Grivas - University of Washington Medical Center
- Resource Type
- Journal article
- Publication Details
- BJU international, Vol.128(2), pp.196-205
- DOI
- 10.1111/bju.15324
- PMID
- 33556233
- NLM abbreviation
- BJU Int
- ISSN
- 1464-4096
- eISSN
- 1464-410X
- Publisher
- Wiley
- Number of pages
- 10
- Grant note
- PS3416 / Wellcome Trust Strategic Fund; Wellcome Trust Kure It Cancer Research UL1 TR002319 / National Center for Advancing Translational Sciences of the National Institutes of Health; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Center for Advancing Translational Sciences (NCATS) Seattle Translational Tumor Research Program at Fred Hutchinson Cancer Research Center T32CA009515 / National Cancer Institute; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Cancer Institute (NCI)
- Language
- English
- Date published
- 08/2021
- Academic Unit
- Hematology, Oncology, and Blood & Marrow Transplantation; Internal Medicine
- Record Identifier
- 9984548376802771
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