Comparison of pembrolizumab with conventional chemotherapy after first‐line platinum‐based chemotherapy for advanced urothelial carcinoma in real‐world practice: A multicenter retrospective study. (24th May 2021)

• Record Type: Journal Article
• Authors: Narita, Takuma; Hatakeyama, Shingo; Numakura, Kazuyuki; Kobayashi, Mizuki; Muto, Yumina; Saito, Mitsuru; Narita, Shintaro; Tanaka, Toshikazu; Noro, Daisuke; Tokui, Noriko; Yoneyama, Takahiro; Hashimoto, Yasuhiro; Habuchi, Tomonori; Ohyama, Chikara
• Is Part Of: International journal of urology. Volume 28:Number 9(2021)
• Page Start: 899
• Page End: 905
• Publication Date: 2021-05-24
• Subjects: chemotherapy -- oncological outcomes -- pembrolizumab -- prognostic factor -- real world -- urothelial carcinoma; Urology -- Periodicals; Genitourinary organs -- Periodicals; Urologic Diseases -- Periodicals; 616.6005
• DOI: 10.1111/iju.14601
• Languages: English
• ISSNs: 0919-8172

Abstract

Abstract : Objectives: To assess the clinical benefit of pembrolizumab as second‐line therapy for advanced urothelial carcinoma. Methods: We retrospectively compared the effects of pembrolizumab with those of conventional chemotherapy on the prognosis of patients with advanced urothelial carcinoma at six hospitals between January 2004 and August 2020. We compared the oncological outcomes between the patients treated with pembrolizumab and those treated with conventional chemotherapy using Kaplan–Meier curve analysis and multivariate Cox regression analysis with the inverse probability of treatment weighting method. Results: The numbers of patients in the pembrolizumab and chemotherapy groups were 121 and 67, respectively. Patients in the pembrolizumab group were significantly older (median 72 vs 66 years, P = 0.001), and had poor Eastern Cooperative Oncology Group performance status (median 1 vs 0, P = 0.001). The unadjusted Kaplan–Meier curve analysis showed no significant differences in the median overall survival from the first‐line chemotherapy (24.7 months vs 16.3 months, P = 0.159). Inverse probability of treatment weighting‐adjusted multivariate Cox proportional hazards analyses showed a significant difference between the pembrolizumab and chemotherapy groups in overall survival ( P = 0.003, hazard ratio 0.63). Conclusions: Despite the non‐negligible age difference between the trial and our clinical practice, our study supports the benefit of second‐line pembrolizumab over chemotherapy in real‐world practice.