Prognostic outcomes and safety in patients treated with pembrolizumab for advanced urothelial carcinoma: experience in real-world clinical practice
Background Prognostic outcomes and safety following treatment with pembrolizumab in patients with advanced urothelial carcinoma (UC) have not been fully elucidated in clinical practice. The aim of this study was to evaluate the oncological efficacy and safety of pembrolizumab after failure of platin...
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| Veröffentlicht in: | International journal of clinical oncology 2020-05, Vol.25 (5), p.899-905 |
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| container_title | International journal of clinical oncology |
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| creator | Tamura, Daichi Jinnouchi, Noriaki Abe, Masakazu Ikarashi, Daiki Matsuura, Tomohiko Kato, Renpei Maekawa, Shigekatsu Kato, Yoichiro Kanehira, Mitsugu Takata, Ryo Obara, Wataru |
| description | Background
Prognostic outcomes and safety following treatment with pembrolizumab in patients with advanced urothelial carcinoma (UC) have not been fully elucidated in clinical practice. The aim of this study was to evaluate the oncological efficacy and safety of pembrolizumab after failure of platinum-based chemotherapy in Japanese patients with advanced UC in a routine clinical setting.
Methods
This retrospective study included 41 consecutive Japanese patients with advanced UC treated with pembrolizumab as second-line or greater therapy at Iwate Medical University Hospital from January 2018 to April 2019.
Results
The mean follow-up period was 6.2 months. The objective response rate, median progression-free survival, and median overall survival were 15%, 2.5 months, and 11.9 months, respectively. Univariate analysis identified poor performance status (> 1), liver metastasis, two or more metastatic organs, low hemoglobin levels, two or more prior regimens, high baseline C-reactive protein levels, higher relative C-reactive protein level change after 6 weeks, and higher relative neutrophil-to-lymphocyte ratio change after 6 weeks as significant predictors of overall survival. Among these factors, poor performance status (> 1), two or more metastatic organs, and higher relative neutrophil-to-lymphocyte ratio change after 6 weeks were identified as independent predictors of overall survival in multivariate analysis.
Conclusions
The introduction of pembrolizumab can result in favorable cancer control outcomes in Japanese patients with advanced UC, and the prognosis of these patients can be stratified according to three potential parameters, including poor performance status, high number of metastatic organs, and higher relative neutrophil-to-lymphocyte ratio change. |
| doi_str_mv | 10.1007/s10147-019-01613-9 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2334239474</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2396572072</sourcerecordid><originalsourceid>FETCH-LOGICAL-c399t-a3733ac3e09c2d9060b80442bd40b151328c5a7803d86144ed3d9b544d69b01d3</originalsourceid><addsrcrecordid>eNp9kc1uFiEUhonR2Fq9AReGxI2b0cPPDB_uTONf0kQXuiYMnK-lYWAExlpvwxuW-lVNXLggkJznPOeEl5DHDJ4zAPWiMmBSDcB0PxMTg75DjpkUalBK8bv9LSQb9MTHI_Kg1ksApqaR3ydHgmnoCByTHx9LPk-5tuBo3prLC1Zqk6fV7rFd05DoalvA1CptBW1DT69Cu6ArLnPJMXzfFjvTfS7U-q82uV7fSm4XGION1NniQsqLfUnx24qlixzeSLsqDle5RE9dDCm4Dq_Fur4HPiT39jZWfHR7n5DPb15_On03nH14-_701dnghNZtsEIJYZ1A0I57DRPMO5CSz17CzEYm-M6NVu1A-N3EpEQvvJ5HKf2kZ2BenJBnB-9a8pcNazNLqA5jtAnzVg0XQnKhpZIdffoPepm3kvp2ndLT2P9S8U7xA-VKrrXg3qwlLLZcGwbmJjJziMz0yMyvyIzuTU9u1du8oP_T8jujDogDUHspnWP5O_s_2p_JyaOK</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2396572072</pqid></control><display><type>article</type><title>Prognostic outcomes and safety in patients treated with pembrolizumab for advanced urothelial carcinoma: experience in real-world clinical practice</title><source>Springer Journals</source><creator>Tamura, Daichi ; Jinnouchi, Noriaki ; Abe, Masakazu ; Ikarashi, Daiki ; Matsuura, Tomohiko ; Kato, Renpei ; Maekawa, Shigekatsu ; Kato, Yoichiro ; Kanehira, Mitsugu ; Takata, Ryo ; Obara, Wataru</creator><creatorcontrib>Tamura, Daichi ; Jinnouchi, Noriaki ; Abe, Masakazu ; Ikarashi, Daiki ; Matsuura, Tomohiko ; Kato, Renpei ; Maekawa, Shigekatsu ; Kato, Yoichiro ; Kanehira, Mitsugu ; Takata, Ryo ; Obara, Wataru</creatorcontrib><description>Background
Prognostic outcomes and safety following treatment with pembrolizumab in patients with advanced urothelial carcinoma (UC) have not been fully elucidated in clinical practice. The aim of this study was to evaluate the oncological efficacy and safety of pembrolizumab after failure of platinum-based chemotherapy in Japanese patients with advanced UC in a routine clinical setting.
Methods
This retrospective study included 41 consecutive Japanese patients with advanced UC treated with pembrolizumab as second-line or greater therapy at Iwate Medical University Hospital from January 2018 to April 2019.
Results
The mean follow-up period was 6.2 months. The objective response rate, median progression-free survival, and median overall survival were 15%, 2.5 months, and 11.9 months, respectively. Univariate analysis identified poor performance status (> 1), liver metastasis, two or more metastatic organs, low hemoglobin levels, two or more prior regimens, high baseline C-reactive protein levels, higher relative C-reactive protein level change after 6 weeks, and higher relative neutrophil-to-lymphocyte ratio change after 6 weeks as significant predictors of overall survival. Among these factors, poor performance status (> 1), two or more metastatic organs, and higher relative neutrophil-to-lymphocyte ratio change after 6 weeks were identified as independent predictors of overall survival in multivariate analysis.
Conclusions
The introduction of pembrolizumab can result in favorable cancer control outcomes in Japanese patients with advanced UC, and the prognosis of these patients can be stratified according to three potential parameters, including poor performance status, high number of metastatic organs, and higher relative neutrophil-to-lymphocyte ratio change.</description><identifier>ISSN: 1341-9625</identifier><identifier>EISSN: 1437-7772</identifier><identifier>DOI: 10.1007/s10147-019-01613-9</identifier><identifier>PMID: 31907720</identifier><language>eng</language><publisher>Singapore: Springer Singapore</publisher><subject>Bladder cancer ; C-reactive protein ; Cancer Research ; Chemotherapy ; Clinical medicine ; Hemoglobin ; Immunotherapy ; Lymphocytes ; Medical prognosis ; Medicine ; Medicine & Public Health ; Metastases ; Metastasis ; Monoclonal antibodies ; Multivariate analysis ; Neutrophils ; Oncology ; Original Article ; Patients ; Pembrolizumab ; Platinum ; Safety ; Surgical Oncology ; Targeted cancer therapy ; Urothelial carcinoma</subject><ispartof>International journal of clinical oncology, 2020-05, Vol.25 (5), p.899-905</ispartof><rights>Japan Society of Clinical Oncology 2020</rights><rights>Japan Society of Clinical Oncology 2020.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c399t-a3733ac3e09c2d9060b80442bd40b151328c5a7803d86144ed3d9b544d69b01d3</citedby><cites>FETCH-LOGICAL-c399t-a3733ac3e09c2d9060b80442bd40b151328c5a7803d86144ed3d9b544d69b01d3</cites><orcidid>0000-0001-9498-9996</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10147-019-01613-9$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10147-019-01613-9$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31907720$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tamura, Daichi</creatorcontrib><creatorcontrib>Jinnouchi, Noriaki</creatorcontrib><creatorcontrib>Abe, Masakazu</creatorcontrib><creatorcontrib>Ikarashi, Daiki</creatorcontrib><creatorcontrib>Matsuura, Tomohiko</creatorcontrib><creatorcontrib>Kato, Renpei</creatorcontrib><creatorcontrib>Maekawa, Shigekatsu</creatorcontrib><creatorcontrib>Kato, Yoichiro</creatorcontrib><creatorcontrib>Kanehira, Mitsugu</creatorcontrib><creatorcontrib>Takata, Ryo</creatorcontrib><creatorcontrib>Obara, Wataru</creatorcontrib><title>Prognostic outcomes and safety in patients treated with pembrolizumab for advanced urothelial carcinoma: experience in real-world clinical practice</title><title>International journal of clinical oncology</title><addtitle>Int J Clin Oncol</addtitle><addtitle>Int J Clin Oncol</addtitle><description>Background
Prognostic outcomes and safety following treatment with pembrolizumab in patients with advanced urothelial carcinoma (UC) have not been fully elucidated in clinical practice. The aim of this study was to evaluate the oncological efficacy and safety of pembrolizumab after failure of platinum-based chemotherapy in Japanese patients with advanced UC in a routine clinical setting.
Methods
This retrospective study included 41 consecutive Japanese patients with advanced UC treated with pembrolizumab as second-line or greater therapy at Iwate Medical University Hospital from January 2018 to April 2019.
Results
The mean follow-up period was 6.2 months. The objective response rate, median progression-free survival, and median overall survival were 15%, 2.5 months, and 11.9 months, respectively. Univariate analysis identified poor performance status (> 1), liver metastasis, two or more metastatic organs, low hemoglobin levels, two or more prior regimens, high baseline C-reactive protein levels, higher relative C-reactive protein level change after 6 weeks, and higher relative neutrophil-to-lymphocyte ratio change after 6 weeks as significant predictors of overall survival. Among these factors, poor performance status (> 1), two or more metastatic organs, and higher relative neutrophil-to-lymphocyte ratio change after 6 weeks were identified as independent predictors of overall survival in multivariate analysis.
Conclusions
The introduction of pembrolizumab can result in favorable cancer control outcomes in Japanese patients with advanced UC, and the prognosis of these patients can be stratified according to three potential parameters, including poor performance status, high number of metastatic organs, and higher relative neutrophil-to-lymphocyte ratio change.</description><subject>Bladder cancer</subject><subject>C-reactive protein</subject><subject>Cancer Research</subject><subject>Chemotherapy</subject><subject>Clinical medicine</subject><subject>Hemoglobin</subject><subject>Immunotherapy</subject><subject>Lymphocytes</subject><subject>Medical prognosis</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Metastases</subject><subject>Metastasis</subject><subject>Monoclonal antibodies</subject><subject>Multivariate analysis</subject><subject>Neutrophils</subject><subject>Oncology</subject><subject>Original Article</subject><subject>Patients</subject><subject>Pembrolizumab</subject><subject>Platinum</subject><subject>Safety</subject><subject>Surgical Oncology</subject><subject>Targeted cancer therapy</subject><subject>Urothelial carcinoma</subject><issn>1341-9625</issn><issn>1437-7772</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kc1uFiEUhonR2Fq9AReGxI2b0cPPDB_uTONf0kQXuiYMnK-lYWAExlpvwxuW-lVNXLggkJznPOeEl5DHDJ4zAPWiMmBSDcB0PxMTg75DjpkUalBK8bv9LSQb9MTHI_Kg1ksApqaR3ydHgmnoCByTHx9LPk-5tuBo3prLC1Zqk6fV7rFd05DoalvA1CptBW1DT69Cu6ArLnPJMXzfFjvTfS7U-q82uV7fSm4XGION1NniQsqLfUnx24qlixzeSLsqDle5RE9dDCm4Dq_Fur4HPiT39jZWfHR7n5DPb15_On03nH14-_701dnghNZtsEIJYZ1A0I57DRPMO5CSz17CzEYm-M6NVu1A-N3EpEQvvJ5HKf2kZ2BenJBnB-9a8pcNazNLqA5jtAnzVg0XQnKhpZIdffoPepm3kvp2ndLT2P9S8U7xA-VKrrXg3qwlLLZcGwbmJjJziMz0yMyvyIzuTU9u1du8oP_T8jujDogDUHspnWP5O_s_2p_JyaOK</recordid><startdate>20200501</startdate><enddate>20200501</enddate><creator>Tamura, Daichi</creator><creator>Jinnouchi, Noriaki</creator><creator>Abe, Masakazu</creator><creator>Ikarashi, Daiki</creator><creator>Matsuura, Tomohiko</creator><creator>Kato, Renpei</creator><creator>Maekawa, Shigekatsu</creator><creator>Kato, Yoichiro</creator><creator>Kanehira, Mitsugu</creator><creator>Takata, Ryo</creator><creator>Obara, Wataru</creator><general>Springer Singapore</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-9498-9996</orcidid></search><sort><creationdate>20200501</creationdate><title>Prognostic outcomes and safety in patients treated with pembrolizumab for advanced urothelial carcinoma: experience in real-world clinical practice</title><author>Tamura, Daichi ; Jinnouchi, Noriaki ; Abe, Masakazu ; Ikarashi, Daiki ; Matsuura, Tomohiko ; Kato, Renpei ; Maekawa, Shigekatsu ; Kato, Yoichiro ; Kanehira, Mitsugu ; Takata, Ryo ; Obara, Wataru</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c399t-a3733ac3e09c2d9060b80442bd40b151328c5a7803d86144ed3d9b544d69b01d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Bladder cancer</topic><topic>C-reactive protein</topic><topic>Cancer Research</topic><topic>Chemotherapy</topic><topic>Clinical medicine</topic><topic>Hemoglobin</topic><topic>Immunotherapy</topic><topic>Lymphocytes</topic><topic>Medical prognosis</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Metastases</topic><topic>Metastasis</topic><topic>Monoclonal antibodies</topic><topic>Multivariate analysis</topic><topic>Neutrophils</topic><topic>Oncology</topic><topic>Original Article</topic><topic>Patients</topic><topic>Pembrolizumab</topic><topic>Platinum</topic><topic>Safety</topic><topic>Surgical Oncology</topic><topic>Targeted cancer therapy</topic><topic>Urothelial carcinoma</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tamura, Daichi</creatorcontrib><creatorcontrib>Jinnouchi, Noriaki</creatorcontrib><creatorcontrib>Abe, Masakazu</creatorcontrib><creatorcontrib>Ikarashi, Daiki</creatorcontrib><creatorcontrib>Matsuura, Tomohiko</creatorcontrib><creatorcontrib>Kato, Renpei</creatorcontrib><creatorcontrib>Maekawa, Shigekatsu</creatorcontrib><creatorcontrib>Kato, Yoichiro</creatorcontrib><creatorcontrib>Kanehira, Mitsugu</creatorcontrib><creatorcontrib>Takata, Ryo</creatorcontrib><creatorcontrib>Obara, Wataru</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>ProQuest Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest Research Library</collection><collection>Research Library (Corporate)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of clinical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tamura, Daichi</au><au>Jinnouchi, Noriaki</au><au>Abe, Masakazu</au><au>Ikarashi, Daiki</au><au>Matsuura, Tomohiko</au><au>Kato, Renpei</au><au>Maekawa, Shigekatsu</au><au>Kato, Yoichiro</au><au>Kanehira, Mitsugu</au><au>Takata, Ryo</au><au>Obara, Wataru</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prognostic outcomes and safety in patients treated with pembrolizumab for advanced urothelial carcinoma: experience in real-world clinical practice</atitle><jtitle>International journal of clinical oncology</jtitle><stitle>Int J Clin Oncol</stitle><addtitle>Int J Clin Oncol</addtitle><date>2020-05-01</date><risdate>2020</risdate><volume>25</volume><issue>5</issue><spage>899</spage><epage>905</epage><pages>899-905</pages><issn>1341-9625</issn><eissn>1437-7772</eissn><abstract>Background
Prognostic outcomes and safety following treatment with pembrolizumab in patients with advanced urothelial carcinoma (UC) have not been fully elucidated in clinical practice. The aim of this study was to evaluate the oncological efficacy and safety of pembrolizumab after failure of platinum-based chemotherapy in Japanese patients with advanced UC in a routine clinical setting.
Methods
This retrospective study included 41 consecutive Japanese patients with advanced UC treated with pembrolizumab as second-line or greater therapy at Iwate Medical University Hospital from January 2018 to April 2019.
Results
The mean follow-up period was 6.2 months. The objective response rate, median progression-free survival, and median overall survival were 15%, 2.5 months, and 11.9 months, respectively. Univariate analysis identified poor performance status (> 1), liver metastasis, two or more metastatic organs, low hemoglobin levels, two or more prior regimens, high baseline C-reactive protein levels, higher relative C-reactive protein level change after 6 weeks, and higher relative neutrophil-to-lymphocyte ratio change after 6 weeks as significant predictors of overall survival. Among these factors, poor performance status (> 1), two or more metastatic organs, and higher relative neutrophil-to-lymphocyte ratio change after 6 weeks were identified as independent predictors of overall survival in multivariate analysis.
Conclusions
The introduction of pembrolizumab can result in favorable cancer control outcomes in Japanese patients with advanced UC, and the prognosis of these patients can be stratified according to three potential parameters, including poor performance status, high number of metastatic organs, and higher relative neutrophil-to-lymphocyte ratio change.</abstract><cop>Singapore</cop><pub>Springer Singapore</pub><pmid>31907720</pmid><doi>10.1007/s10147-019-01613-9</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0001-9498-9996</orcidid></addata></record> |
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| ispartof | International journal of clinical oncology, 2020-05, Vol.25 (5), p.899-905 |
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| source | Springer Journals |
| subjects | Bladder cancer C-reactive protein Cancer Research Chemotherapy Clinical medicine Hemoglobin Immunotherapy Lymphocytes Medical prognosis Medicine Medicine & Public Health Metastases Metastasis Monoclonal antibodies Multivariate analysis Neutrophils Oncology Original Article Patients Pembrolizumab Platinum Safety Surgical Oncology Targeted cancer therapy Urothelial carcinoma |
| title | Prognostic outcomes and safety in patients treated with pembrolizumab for advanced urothelial carcinoma: experience in real-world clinical practice |
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