論文

国際誌
2021年2月

Risk stratification for the prognosis of patients with chemoresistant urothelial cancer treated with pembrolizumab.

Cancer science
  • Takashi Kobayashi
  • ,
  • Katsuhiro Ito
  • ,
  • Takahiro Kojima
  • ,
  • Minoru Kato
  • ,
  • Souhei Kanda
  • ,
  • Shingo Hatakeyama
  • ,
  • Yoshiyuki Matsui
  • ,
  • Yuto Matsushita
  • ,
  • Sei Naito
  • ,
  • Masanobu Shiga
  • ,
  • Makito Miyake
  • ,
  • Yusuke Muro
  • ,
  • Shotaro Nakanishi
  • ,
  • Yoichiro Kato
  • ,
  • Tadamasa Shibuya
  • ,
  • Tetsutaro Hayashi
  • ,
  • Hiroaki Yasumoto
  • ,
  • Takashi Yoshida
  • ,
  • Motohide Uemura
  • ,
  • Rikiya Taoka
  • ,
  • Manabu Kamiyama
  • ,
  • Osamu Ogawa
  • ,
  • Hiroshi Kitamura
  • ,
  • Hiroyuki Nishiyama

112
2
開始ページ
760
終了ページ
773
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1111/cas.14762

The use of immune checkpoint inhibitors to treat urothelial carcinoma (UC) is increasing rapidly without clear guidance for validated risk stratification. This multicenter retrospective study collected clinicopathological information on 463 patients, and 11 predefined variables were analyzed to develop a multivariate model predicting overall survival (OS). The model was validated using an independent dataset of 292 patients. Patient characteristics and outcomes were well balanced between the discovery and validation cohorts, which had median OS times of 10.2 and 12.5 mo, respectively. The final validated multivariate model was defined by risk scores based on the hazard ratios (HRs) of independent prognostic factors including performance status, site of metastasis, hemoglobin levels, and the neutrophil-to-lymphocyte ratio. The median OS times (95% confidence intervals [CIs]) for the low-, intermediate-, and high-risk groups (discovery cohort) were not yet reached (NYR) (NYR-19.1), 6.8 mo (5.8-8.9), and 2.3 mo (1.2-2.6), respectively. The HRs (95% CI) for OS in the low- and intermediate-risk groups vs the high-risk group were 0.07 (0.04-0.11) and 0.23 (0.15-0.37), respectively. The objective response rates for in the low-, intermediate-, and high-risk groups were 48.3%, 28.8%, and 10.5%, respectively. These differential outcomes were well reproduced in the validation cohort and in patients who received pembrolizumab after perioperative or first-line chemotherapy (N = 584). In conclusion, the present study developed and validated a simple prognostic model predicting the oncological outcomes of pembrolizumab-treated patients with chemoresistant UC. The model provides useful information for external validation, patient counseling, and clinical trial design.

リンク情報
DOI
https://doi.org/10.1111/cas.14762
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/33283385
PubMed Central
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7893997
ID情報
  • DOI : 10.1111/cas.14762
  • PubMed ID : 33283385
  • PubMed Central 記事ID : PMC7893997

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