Prognostic factors in patients with metastatic urothelial carcinoma who have treated with Atezolizumab

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dc.contributor.authorTural, Deniz
dc.contributor.authorOlmez, Omer Fatih
dc.contributor.authorSumbul, Ahmet Taner
dc.contributor.authorOzhan, Nail
dc.contributor.authorCakar, Burcu
dc.contributor.authorKostek, Osman
dc.contributor.authorEkenel, Meltem
dc.date.accessioned2024-02-23T13:55:58Z
dc.date.available2024-02-23T13:55:58Z
dc.date.issued2021
dc.departmentNEÜen_US
dc.description.abstractBackground Atezolizumab (ATZ) has demonstrated antitumor activity and manageable safety in previous studies of patients with metastatic platinum-resistant urothelial carcinoma. However, the response rate of Atezolizumab was modest. In the current study, we evaluated the pretreatment prognostic factors for overall survival in patients with metastatic urothelial carcinoma who have progressed after first-line chemotherapy in the Expanded-Access Program of Atezolizumab. Patients and methods In this study, we present a retrospective analysis of 113 patients with urothelial cancer treated with ATZ after progression on first-line chemotherapy. Data of the patients was obtained from patient files and hospital records. Eligible patients included metastatic urothelial carcinoma patients treated with at least one course of ATZ. Univariate analysis was used to identify clinical and laboratory factors that significantly impact OS. Variables were retained for multivariate analysis if they had a statistical relationship with OS (p < 0.1), and then included a final model of p < 0.05. Results The median follow-up duration was 23.5 months. Of the patients, 98 (86.7%) were male and 13.3% were female. The median age was 65 years of age (37-86). In univariate analysis, primary tumor location in the upper tract, increasing absolute neutrophil count (ANC), increasing absolute lymphocyte count, neutrophil-to-lymphocyte ratio (NLR) > 3, liver metastases, baseline creatinine clearance less (GFR) than 60 ml/min, Eastern Cooperative Oncology Group (ECOG) performance status (1 >=), and hemoglobin levels below 10 mg/dl were all the significantly associated with OS. Three of the five adverse prognostic factors according to the Bellmunt criteria were independent of short survival: liver metastases HR 3.105; 95% CI 1.673-5.761; p < (0.001), ECOG PS (1 >=) HR 2.184; 95% CI 1.120-4.256; p = 0.022, and Hemoglobin level below 10 mg/dl HR 2.680; 95% CI 1.558-4.608; p < (0.001). In addition, NLR > 3 hazard ratio [HR] 2.092; 95% CI 1.031-4.243; p = 0.041 and GFR less than 60 ml/min HR 1.829; 95% CI 1.1-3.041; p = 0.02, maintained a significant association with OS in multivariate analysis. Conclusions This model confirms the Bellmunt model with the addition of NLR > 3 and GFR less than 60 ml/min and can be associated with clinical trials that use immunotherapy in patients with bladder cancer.en_US
dc.identifier.doi10.1007/s10147-021-01936-6
dc.identifier.endpage1513en_US
dc.identifier.issn1341-9625
dc.identifier.issn1437-7772
dc.identifier.issue8en_US
dc.identifier.pmid34023933en_US
dc.identifier.scopus2-s2.0-85106432319en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.startpage1506en_US
dc.identifier.urihttps://doi.org/10.1007/s10147-021-01936-6
dc.identifier.urihttps://hdl.handle.net/20.500.12452/11040
dc.identifier.volume26en_US
dc.identifier.wosWOS:000653022600001en_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/closedAccessen_US
dc.subjectAtezolizumaben_US
dc.subjectUrothelial Carcinomaen_US
dc.subjectBladder Canceren_US
dc.subjectImmunotherapyen_US
dc.titlePrognostic factors in patients with metastatic urothelial carcinoma who have treated with Atezolizumaben_US
dc.typeArticleen_US

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