University of California San Francisco, Helen Diller Family Cancer Center, San Francisco, CA.
Tulane University Medical School, New Orleans, LA.
Clin Genitourin Cancer. 2022 Apr;20(2):189-194. doi: 10.1016/j.clgc.2021.12.009. Epub 2021 Dec 16.
Immune checkpoint inhibitors (ICIs) have become one of the mainstays of systemic therapy for advanced urothelial carcinoma (aUC). Increasingly ICIs are also being utilized earlier in the course of UC treatment. Limited data are available regarding ICI treatment efficacy in aUC patients who have progressed on prior ICI regimens. This case series aims to address this knowledge gap.
We identified all aUC patients treated with ICI or combination following prior progression on another ICI regimen at two academic institutions. Patient demographic, clinicopathologic and treatment data were retrospectively collected from chart review at each site. Best response to ICI treatment was defined by investigator at each site.
Among 7 patients with aUC who received ICI treatment following prior progression on a different ICI regimen, radiographic response to the second ICI regimen was observed in only 1 patient (14%) treated with combination of pembrolizumab/enfortumab vedotin.
Efficacy of ICI treatment in patients who previously progressed on another ICI regimen appears limited. These observations should be validated in larger cohorts, as it is anticipated that this clinical scenario will become more common in the future.
免疫检查点抑制剂（ICI）已成为晚期尿路上皮癌（aUC）系统治疗的主要方法之一。越来越多的ICI 也被更早地用于 UC 的治疗过程中。关于先前接受 ICI 方案治疗后进展的 aUC 患者，ICI 治疗的疗效数据有限。本病例系列旨在填补这一知识空白。
我们在两个学术机构中确定了所有在先前的 ICI 方案进展后接受 ICI 或联合治疗的 aUC 患者。从每个地点的图表审查中回顾性收集患者的人口统计学、临床病理学和治疗数据。每个地点的研究者根据最佳反应来定义 ICI 治疗的反应。
在先前接受不同 ICI 方案治疗后进展的 7 名 aUC 患者中，仅 1 名（14%）接受 pembrolizumab/enfortumab vedotin 联合治疗的患者观察到第二次 ICI 方案的影像学反应。
先前接受另一种 ICI 方案治疗后进展的患者的 ICI 治疗效果似乎有限。这些观察结果应在更大的队列中得到验证，因为预计这种临床情况在未来会更加常见。
