Response to first-line chemotherapy regimen is associated with efficacy of immune checkpoint blockade therapies in patients with metastatic urothelial carcinoma

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dc.contributor.authorTural, Deniz
dc.contributor.authorSelcukbiricik, Fatih
dc.contributor.authorOlmez, Omer Fatih
dc.contributor.authorSumbul, Ahmet Taner
dc.contributor.authorErman, Mustafa
dc.contributor.authorCoskun, Hasan Senol
dc.contributor.authorArtac, Mehmet
dc.date.accessioned2024-02-23T13:55:58Z
dc.date.available2024-02-23T13:55:58Z
dc.date.issued2022
dc.departmentNEÜen_US
dc.description.abstractBackground Atezolizumab (ATZ) has demonstrated antitumor activity in previous studies in patients with metastatic platinum-resistant urothelial carcinoma. However, the response rate of ATZ was modest. Therefore, finding biologic or clinical biomarkers that could help to select patients who respond to the immune checkpoint blockade remains important. Patients and methods In this study, we present the retrospective analysis of 105 patients with urothelial cancer treated with ATZ after progression on first-line chemotherapy. Data of patients were obtained from patient files and hospital records. The association between response to first-line chemotherapy and ATZ was using Fisher's exact test. Median follow-up was calculated using the reverse Kaplan-Meier method. OS was estimated by using the Kaplan-Meier method. Results The median follow-up time was 23.5 months. Forty (74.1%) of patients who experienced clinical benefit after firs-line chemotherapy also had clinical benefit after atezolizumab, while only 14 (25.9%) of patients with initial PD after first-line chemotherapy subsequently experienced clinical benefit with ATZ (p = 0.001). The median OS on ATZ of 14.8 and 3.4 months for patients with clinical benefit and progressive disease in response to first-line chemotherapy, respectively (p = 0.001). Three of the adverse prognostic factors according to the Bellmunt criteria were independent factors of short survival: liver metastases {Hazard ratio [HR] = 1.9; p = 0.04}, ECOG PS >= 1 (HR = 2.7; p = 0.001), and Hemoglobin level below 10 mg/dl (HR = 2.8; p < 0.001). In addition, patients with clinical benefit from first-line chemotherapy (HR = 0.39; p < 0.001) maintained a significant association with OS in multivariate analysis. Conclusions Our study demonstrated that clinical benefit from first-line chemotherapy was independent prognostic factors on OS in patients' use of ATZ as second-line treatment in metastatic bladder cancer. Furthermore, these findings are important for stratification factors for future immunotherapy study design in patients with bladder cancer who have progressed after first-line chemotherapy.en_US
dc.identifier.doi10.1007/s10147-021-02072-x
dc.identifier.endpage591en_US
dc.identifier.issn1341-9625
dc.identifier.issn1437-7772
dc.identifier.issue3en_US
dc.identifier.pmid34762201en_US
dc.identifier.scopus2-s2.0-85118901226en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.startpage585en_US
dc.identifier.urihttps://doi.org/10.1007/s10147-021-02072-x
dc.identifier.urihttps://hdl.handle.net/20.500.12452/11041
dc.identifier.volume27en_US
dc.identifier.wosWOS:000717459000001en_US
dc.identifier.wosqualityQ3en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherSpringer Japan Kken_US
dc.relation.ispartofInternational Journal Of Clinical Oncologyen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectAtezolizumaben_US
dc.subjectUrothelial Carcinomaen_US
dc.subjectBladder Canceren_US
dc.subjectChemotherapyen_US
dc.subjectImmunotherapyen_US
dc.subjectOutcomesen_US
dc.titleResponse to first-line chemotherapy regimen is associated with efficacy of immune checkpoint blockade therapies in patients with metastatic urothelial carcinomaen_US
dc.typeArticleen_US

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