Disease control with prior platinum-based chemotherapy is prognostic for survival in patients with metastatic urothelial cancer treated with atezolizumab in real-world practice
Introduction: Atezolizumab, programmed-death ligand-1 (PD-L1) inhibitor, is a novel treatment option for patients with metastatic urothelial cancer (mUC). Clinical prognostic factors, survival outcomes and safety of patients with mUC treated with atezolizumab, in a real-world setting, were investigated.
Methods: 62 patients with mUC, treated at the Institute of Oncology Ljubljana, between May 8th, 2018 and Dec 31st, 2019, were included. Response rates and immune-related adverse events (irAE) were collected. Progression-free survival and overall survival times were assessed using the Kaplan–Meier method. Cox proportional hazards model was applied to identify the factors affecting survival.
Results: Of 62 patients, 5 (8.1%) have not been evaluated yet and 20 (32%) died prior to first radiographic evaluation. We observed clinical benefit in 19 (33%), objective response in 12 (21%) and complete response in 5 (9 %) patients. Median overall survival for the whole population was 6.8 (95% CI: 2,6-11,0), for chemo-naïve 8.7 (CI 95%:0.8-16.5) and for chemo–exposed group 6.8 (CI 95%:3.7-10) months. At 5.8 (0.3 – 23.1) months median follow-up, the median duration of response was not reached. IrAE occurred in 20 (32 %) patients and 7 (11%) of them discontinued the treatment. Multivariant analysis in platinum-treated showed that treatment- free interval more than 6 months is prognostic for OS.
Conclusion: Responses to atezolizumab led to long disease remission in a subset of our patients. The mOS in our real-world population was compromised by a large percentage of patients with poor ECOG PS. Treatment free interval from chemotherapy is associated with longer survival of platinum-treated patients with mUC receiving further atezolizumab.
How to Cite
Copyright (c) 2021 Radiology and Oncology
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
License to Publish
Please read the terms of this agreement, print, initial page 1, sign page 3, scan and send the document as one file attached to an e-mail to firstname.lastname@example.org