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Disease control with prior platinum-based chemotherapy is prognostic for survival in patients with metastatic urothelial cancer treated with atezolizumab in real-world practice

Marina Mencinger
Marina Mencinger
, 
Dusan Mangaroski
Dusan Mangaroski
 oraz 
Urska Bokal
Urska Bokal
   | 04 maj 2021
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Article Category: Research Article
Data publikacji: 04 maj 2021
Zakres stron: 491 - 498
Otrzymano: 27 wrz 2021
Przyjęty: 07 mar 2021
DOI: https://doi.org/10.2478/raon-2021-0021
© 2021 Marina Mencinger, Dusan Mangaroski, Urska Bokal, published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Figure 1

Kaplan-Meier curves of progression-free survival (A) and overall survival (B) of all study population.
Kaplan-Meier curves of progression-free survival (A) and overall survival (B) of all study population.

Figure 2

Kaplan-Meier curves of overall survival according to the previous exposure to chemotherapy.
Kaplan-Meier curves of overall survival according to the previous exposure to chemotherapy.

Figure 3

Duration of responses at a median follow up of 5.8 (0.3 – 23.1) months.
Duration of responses at a median follow up of 5.8 (0.3 – 23.1) months.

Immune-related adverse events

IrAE of any grade 20 (32%)
IrAE ≥ Grade 3/4 7 (11%)
Systemic corticosteroid use 5 (8%)
Atezolizumab discontinuation due to IrAE 7 (11%)

Univariant and multivariant analysis of prognostic factors (correlation with overall survival)

Subgroup Univariant HR p Multivariant HR p Reference category
Age 0.861 (0.428-1.731) 0.675 ≥ 75 years
ECOG PS 2.883 (1.495-5.559) 0.002 3.449 (1.358-8.761) 0.009 2 or 3
Visceral metastases* 0.965 (0.502-1.853) 0.914 Yes
Clinical benefit to previous chemotherapy 0.319 (0.133-0.765) 0.010 0.355 (0.131-0.961) 0.042 Yes
TFI 0.140 (0.032-0.604) 0.008 0.113 (0.014-0.877) 0.037 > 6 months
IrAE 0.566 (0.266-1.202) 0.139 Yes

Patients’ characteristics

Platinum-treated N=44 (%) Platinum-naïve N=18 (%)
Median age, years (range) 65 (48-80) 75 (62-85)
Age ≥ 75 years 7 (16) 12 (67)
Sex
Male/Female 27 (61)/17 (39) 11 (61)/7 (39)
ECOG PS
0,1/2,3 26 (59)/18 (41) 10 (56)/8 (44)
Primary metastatic disease 23 (52) 14 (78)
Metastatic nonvisceral/site visceral/hepatic 14 (32)/30 (68)/18 (41) 13 (72)/5 (28)/0
Pure urothelial histology 35 (80) 15 (83)
PD-L1 status
0-4% 9 (20) 1 (5)
≥5 % 10 (23) 12 (67)
Unknown 25 (57) 5 (28)
Treatment modalities before atezolizumab
Perioperative chemotherapy 14 (32)
Surgery 25 (57) 10 (56)
Chemotherapy disease for metastatic Number of chemotherapy lines for metastatic disease before atezolizumab 30 (68)
1/2 28 (93)/2 (7)

Responses to treatment with atezolizumab

Type of response All patients N=57 (%) Patients with liver metastases N=16 (28%) Platinum-naive N=17 (30%) Platinum-treated N=40 (70%) ECOG PS 0+1 N=33 (58%) ECOG PS 2+3 N=24 (42%)
CR 5 (9) 0 (0) 3 (17.5) 2 (5) 4 (12) 1 (4.2)
PR 7 (12) 1 (6) 3 (17.5) 4 (10) 5 (15) 2 (8.3)
SD 7 (12) 4 (25) 1 (6) 6 (15) 6 (18) 1 (4.2)
PD 38 (67) 11 (69) 10 (59) 28 (70) 18 (55) 20 (83.3)
eISSN:
1581-3207
Język:
Angielski
Częstotliwość wydawania:
4 razy w roku
Dziedziny czasopisma:
Medicine, Clinical Medicine, Internal Medicine, Haematology, Oncology, Radiology
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