Clinical outcome after progressing to frontline and second-line Anti-PD-1/PD-L1 in advanced urothelial cancer. European urology

Alfonso Gómez de Liaño Lista, Nick van Dijk, Guillermo de Velasco Oria de Rueda, Andrea Necchi, Pernelle Lavaud, Rafael Morales-Barrera, Teresa Alonso Gordoa, Pablo Maroto, Alain Ravaud, Ignacio Durán, Bernadett Szabados, Daniel Castellano, Patrizia Giannatempo, Yohann Loriot, Joan Carles, Georgia Anguera Palacios, Felix Lefort, Daniele Raggi, Marine Gross Goupil, Thomas PowlesMichiel S. Van der Heijden

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: Immune checkpoint inhibitors (ICIs) are approved for first-line (cisplatin unfit, PD-L1+) and platinum-refractory urothelial carcinoma (UC). Still, most patients experience progressive disease (PD) as the best response. Although higher response rates to subsequent systemic treatment (SST) have been described, post-PD outcome data are scarce. OBJECTIVE: To examine the outcome of UC patients who received SST and no SST after progressing to ICIs. DESIGN, SETTING, AND PARTICIPANTS: A retrospective analysis of UC patients progressing to frontline or later-line anti-PD-1/PD-L1 therapy in 10 European institutions was conducted between March 2013 and September 2017. INTERVENTION: Post-PD management as per standard practice. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Overall survival (OS) was analyzed with a Kaplan-Meier model. Cox regression was used for multivariate analysis (MV). Impact of SST on OS was examined with a time-varying covariate model. RESULTS AND LIMITATIONS: A total of 270 UC patients with PD to ICIs (69 frontline, 201 later line) were analyzed. Of the patients, 57% of frontline-ICI-PD and 34% of later-line-ICI-PD patients received SST, and SST had an impact on OS in MV (frontline: hazard ratio [HR] 0.22, 95% confidence interval [CI] 0.10-0.51, p 
Original languageEnglish
Pages (from-to)269-276
Number of pages8
JournalEuropean Urology
Volume77
Issue number2
DOIs
Publication statusPublished - 2020

Keywords

  • *Immunotherapy
  • *PD-L1
  • *Immune checkpoint inhibitors
  • *Urothelial carcinoma
  • *PD-1
  • *Bladder cancer

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