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

Autor: Tural D; Department of Medical Oncology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Zuhuratbaba District, Tevfik Saglam St. No: 11, Bakirkoy, Istanbul, Turkey. deniztural@gmail.com., Ölmez ÖF; Medical Oncology, Medipol University Hospital, Istanbul, Turkey., Sümbül AT; Medical Oncology, Baskent University Medical Faculty, Adana, Turkey., Özhan N; Medical Oncology, Pamukkale University Medical Faculty, Denizli, Turkey., Çakar B; Medical Oncology, Ege University Medical Faculty, Izmir, Turkey., Köstek O; Medical Oncology, Trakya University Medical Faculty, Edirne, Turkey., Ekenel M; Medical Oncology, Istanbul University Institute of Oncology, Istanbul, Turkey., Erman M; Medical Oncology, Hacettepe University Medical Faculty, Ankara, Turkey., Coşkun HŞ; Medical Oncology, Akdeniz University Medical Faculty, Antalya, Turkey., Selçukbiricik F; Medical Oncology, Koc University Medical Faculty, Istanbul, Turkey., Keskin Ö; Medical Oncology, Selcuk University Medical Faculty, Konya, Turkey., Türköz FP; Istinye Universty, MedicalPark Goztepe Hospital, Istanbul, Turkey., Oruç K; Medical Oncology, Istanbul University-Cerrahpasa Medical Faculty, Istanbul, Turkey., Bayram S; Medical Oncology, Antalya Training and Research Hospital, Antalya, Turkey., Bilgetekin İ; Medical Oncology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey., Yıldız B; Medical Oncology, Gulhane Training and Research Hospital, Ankara, Turkey., Şendur MAN; Medical Oncology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey., Paksoy N; Medical Oncology, Hacettepe University Medical Faculty, Ankara, Turkey., Dirican A; Medical Oncology, Celal Bayar University Medical Faculty, Manisa, Turkey., Erdem D; Medical Oncology, Medical Park Samsun Hospital, Samsun, Turkey., Selam M; Medical Oncology, Liv Hospital, Istanbul, Turkey., Tanrıverdi Ö; Medical Oncology, Sitki Kocman University Medical Faculty, Mugla, Turkey., Paydaş S; Medical Oncology, Cukurova University Medical Faculty, Adana, Turkey., Urakçı Z; Medical Oncology, Dicle University Medical Faculty, Diyarbakir, Turkey., Atağ E; Medical Oncology, Dokuz Eylul University Medical Faculty, Izmir, Turkey., Güncan S; Medical Oncology, Mersin University Medical Faculty, Mersin, Turkey., Ürün Y; Medical Oncology, Ankara University Medical Faculty, Ankara, Turkey., Alkan A; Medical Oncology, Osmaniye State Hospital, Osmaniye, Turkey., Kaya AO; Medical Oncology, Medicana Hospital, Istanbul, Turkey., Özyükseler DT; Medical Oncology, Istanbul Kartal Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, Turkey., Taşkaynatan H; Medical Oncology, Katip Celebi University Atatürk Training and Research Hospital, Izmir, Turkey., Yıldırım M; Medical Oncology, Medical Park Gaziantep Hospital, Gaziantep, Turkey., Sönmez M; Medical Oncology, Ordu State Hospital, Ordu, Turkey., Başoğlu T; Medical Oncology, Marmara University Medical Faculty, Istanbul, Turkey., Gündüz Ş; Medical Oncology, Antalya Memorial Hospital, Antalya, Turkey., Kılıçkap S; Medical Oncology, Istinye University Medical Faculty, Liv Hospital, Ankara, Turkey., Artaç M; Medical Oncology, Necmettin Erbakan University Meram Medical Faculty, Konya, Turkey.
Jazyk: angličtina
Zdroj: International journal of clinical oncology [Int J Clin Oncol] 2021 Aug; Vol. 26 (8), pp. 1506-1513. Date of Electronic Publication: 2021 May 23.
DOI: 10.1007/s10147-021-01936-6
Abstrakt: Background: 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.
(© 2021. Japan Society of Clinical Oncology.)
Databáze: MEDLINE
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