BACKGROUND: Little is known about the outcomes, safety, and response to subsequent therapies of patients with metastatic urothelial carcinoma (mUC) treated with atezolizumab outside clinical trials. OBJECTIVES: The objectives of the study include to report the clinical efficacy and safety of atezolizumab, and the response to future therapies in clinical practice outside clinical trials. PATIENT AND METHODS: This is a retrospective, single-center study including consecutive patients with confirmed mUC who received at least one dose of atezolizumab 1200 mg every 3 weeks between May 2016 and April 2017. RESULTS: Seventy-nine patients, median age 72 years (range 29-93), 71% men and 76% ECOG PS 0-1, were identified. Most patients (79%) had primary cancer in the bladder, 62% had prior surgery, and 75% received at least one prior line of treatment (34 patients had prior cisplatin-based chemotherapy). Best response included 18% partial response, 29% stable disease, and 53% progressive disease. Patients were on atezolizumab for a median of 2.7 months (95%CI, 1.8-3.6) and median PFS was 3.2 months (95%CI, 1.6-4.8). A total of 33 (42%) patients had significant (any cause) AEs, including grade 4 hyperbilirubinemia in two patients; no toxic deaths were reported. At time of data analysis, only 18% of patients received at least one subsequent line of treatment for a median of 1.8 months (95%CI, 0.0-5.0) while 42% were referred to palliative care/hospice or died. CONCLUSIONS: Patients with mUC who progressed on atezolizumab were unlikely to receive subsequent systemic treatments and the benefit of those treatments appeared limited in our cohort. The findings may impact timing and designs of clinical trials in mUC.
BACKGROUND: Little is known about the outcomes, safety, and response to subsequent therapies of patients with metastatic urothelial carcinoma (mUC) treated with atezolizumab outside clinical trials. OBJECTIVES: The objectives of the study include to report the clinical efficacy and safety of atezolizumab, and the response to future therapies in clinical practice outside clinical trials. PATIENT AND METHODS: This is a retrospective, single-center study including consecutive patients with confirmed mUC who received at least one dose of atezolizumab 1200 mg every 3 weeks between May 2016 and April 2017. RESULTS: Seventy-nine patients, median age 72 years (range 29-93), 71% men and 76% ECOG PS 0-1, were identified. Most patients (79%) had primary cancer in the bladder, 62% had prior surgery, and 75% received at least one prior line of treatment (34 patients had prior cisplatin-based chemotherapy). Best response included 18% partial response, 29% stable disease, and 53% progressive disease. Patients were on atezolizumab for a median of 2.7 months (95%CI, 1.8-3.6) and median PFS was 3.2 months (95%CI, 1.6-4.8). A total of 33 (42%) patients had significant (any cause) AEs, including grade 4 hyperbilirubinemia in two patients; no toxic deaths were reported. At time of data analysis, only 18% of patients received at least one subsequent line of treatment for a median of 1.8 months (95%CI, 0.0-5.0) while 42% were referred to palliative care/hospice or died. CONCLUSIONS:Patients with mUC who progressed on atezolizumab were unlikely to receive subsequent systemic treatments and the benefit of those treatments appeared limited in our cohort. The findings may impact timing and designs of clinical trials in mUC.
Authors: D F Bajorin; P M Dodd; M Mazumdar; M Fazzari; J A McCaffrey; H I Scher; H Herr; G Higgins; M G Boyle Journal: J Clin Oncol Date: 1999-10 Impact factor: 44.544
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Authors: Arjun V Balar; Matthew D Galsky; Jonathan E Rosenberg; Thomas Powles; Daniel P Petrylak; Joaquim Bellmunt; Yohann Loriot; Andrea Necchi; Jean Hoffman-Censits; Jose Luis Perez-Gracia; Nancy A Dawson; Michiel S van der Heijden; Robert Dreicer; Sandy Srinivas; Margitta M Retz; Richard W Joseph; Alexandra Drakaki; Ulka N Vaishampayan; Srikala S Sridhar; David I Quinn; Ignacio Durán; David R Shaffer; Bernhard J Eigl; Petros D Grivas; Evan Y Yu; Shi Li; Edward E Kadel; Zachary Boyd; Richard Bourgon; Priti S Hegde; Sanjeev Mariathasan; AnnChristine Thåström; Oyewale O Abidoye; Gregg D Fine; Dean F Bajorin Journal: Lancet Date: 2016-12-08 Impact factor: 79.321
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Authors: Andrea B Apolo; Jeffrey R Infante; Ani Balmanoukian; Manish R Patel; Ding Wang; Karen Kelly; Anthony E Mega; Carolyn D Britten; Alain Ravaud; Alain C Mita; Howard Safran; Thomas E Stinchcombe; Marko Srdanov; Arnold B Gelb; Michael Schlichting; Kevin Chin; James L Gulley Journal: J Clin Oncol Date: 2017-04-04 Impact factor: 44.544
Authors: Scott T Tagawa; Arjun V Balar; Daniel P Petrylak; Arash Rezazadeh Kalebasty; Yohann Loriot; Aude Fléchon; Rohit K Jain; Neeraj Agarwal; Manojkumar Bupathi; Philippe Barthelemy; Philippe Beuzeboc; Phillip Palmbos; Christos E Kyriakopoulos; Damien Pouessel; Cora N Sternberg; Quan Hong; Trishna Goswami; Loretta M Itri; Petros Grivas Journal: J Clin Oncol Date: 2021-04-30 Impact factor: 50.717
Authors: Ali Raza Khaki; Ang Li; Leonidas N Diamantopoulos; Mehmet A Bilen; Victor Santos; John Esther; Rafael Morales-Barrera; Michael Devitt; Ariel Nelson; Christopher J Hoimes; Evan Shreck; Hussein Assi; Benjamin A Gartrell; Alex Sankin; Alejo Rodriguez-Vida; Mark Lythgoe; David J Pinato; Alexandra Drakaki; Monika Joshi; Pedro Isaacsson Velho; Noah Hahn; Sandy Liu; Lucia Alonso Buznego; Ignacio Duran; Marcus Moses; Jayanshu Jain; Jure Murgic; Praneeth Baratam; Pedro Barata; Abhishek Tripathi; Yousef Zakharia; Matthew D Galsky; Guru Sonpavde; Evan Y Yu; Veena Shankaran; Gary H Lyman; Petros Grivas Journal: Cancer Date: 2019-12-12 Impact factor: 6.921