Medical Oncology Department, Hospital Universitario Marques de Valdecilla, Santander, Spain.
School of Medicine, University of Cantabria, Santander, Spain.
Clin Transl Oncol. 2024 Mar;26(3):682-688. doi: 10.1007/s12094-023-03288-1. Epub 2023 Aug 4.
Immune checkpoint inhibitors (ICIs) have been incorporated in the treatment of metastatic urothelial carcinoma (mUC) upon platinum-based chemotherapy according to the positive results of large clinical trials. Nevertheless, results from unselected populations reflecting real-world data (RWD) are highly informative to the clinician. We reviewed daily clinical practice outcomes in patients with mUC who received atezolizumab in our institution.
Here we evaluated the clinical activity and safety of atezolizumab in an unselected population of mUC patients who received atezolizumab between 2018 and 2022 reflecting RWD. Efficacy and safety information were retrospectively collected.
A total of 63 patients were included. The mean age was 68 years and the objective response rate was 14.3%. The median progression-free survival was 3 months and the median overall survival 6 months. At 1 year, 42% of the patients were alive. ECOG (0 vs 1) and neutrophil-lymphocytes ratio < 2 at the start of ICI were positive prognostic factors that discriminated between long vs short survivors. Overall tolerance was good with no new safety signals. Five patients (17%) had treatment-related adverse events grade ≥ 2 that required corticosteroids.
In this retrospective study, atezolizumab was an effective and tolerable treatment option for patients with mUC after progression to platinum-based chemotherapy. Yet, patient selection remains critical to improve outcomes.
基于大型临床试验的阳性结果，免疫检查点抑制剂（ICI）已被纳入铂类化疗后转移性尿路上皮癌（mUC）的治疗中。然而，来自反映真实世界数据（RWD）的未经选择的人群的结果对临床医生来说非常有信息量。我们回顾了在我们机构接受阿替利珠单抗治疗的 mUC 患者的日常临床实践结果。
在这里，我们评估了阿替利珠单抗在 mUC 患者中的临床疗效和安全性，这些患者在 2018 年至 2022 年间接受了阿替利珠单抗治疗，反映了 RWD。回顾性收集了疗效和安全性信息。
共纳入 63 例患者。患者的平均年龄为 68 岁，客观缓解率为 14.3%。中位无进展生存期为 3 个月，中位总生存期为 6 个月。在 1 年时，42%的患者存活。ECOG（0 与 1）和开始 ICI 时中性粒细胞-淋巴细胞比值<2 是区分长生存期和短生存期的阳性预后因素。总体耐受性良好，无新的安全信号。5 名患者（17%）发生了需要皮质类固醇治疗的治疗相关不良事件≥2 级。
在这项回顾性研究中，阿替利珠单抗是铂类化疗后进展的 mUC 患者的一种有效且耐受良好的治疗选择。然而，患者选择仍然是提高疗效的关键。
