Association Between Sites of Metastasis and Outcomes With Immune Checkpoint Inhibitors in Advanced Urothelial Carcinoma.
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Makrakis Dimitrios, Talukder Rafee, Lin Genevieve Ihsiu, Diamantopoulos Leonidas N, Dawsey Scott, Gupta Shilpa, Carril-Ajuria Lucia, Castellano Daniel, de Kouchkovsky Ivan, Koshkin Vadim S, Park Joseph J, Alva Ajjai, Bilen Mehmet A, Stewart Tyler F, McKay Rana R, Tripathi Nishita, Agarwal Neeraj, Vather-Wu Naomi, Zakharia Yousef, Morales-Barrera Rafael, Devitt Michael E, Cortellini Alessio, Fulgenzi Claudia Angela Maria, Pinato David J, Nelson Ariel, Hoimes Christopher J, Gupta Kavita, Gartrell Benjamin A, Sankin Alex, Tripathi Abhishek, Zakopoulou Roubini, Bamias Aristotelis, Murgic Jure, Fröbe Ana, Rodriguez-Vida Alejo, Drakaki Alexandra, Liu Sandy, Lu Eric, Kumar Vivek, Lorenzo Giuseppe Di, Joshi Monika, Isaacsson-Velho Pedro, Buznego Lucia Alonso, Duran Ignacio, Moses Marcus, Jang Albert, Barata Pedro, Sonpavde Guru, Yu Evan Y, Montgomery Robert Bruce, Grivas Petros, Khaki Ali Raza
Аннотация
METHODS: We identified a retrospective cohort of patients with aUC across 26 institutions, collecting demographics, clinicopathological, treatment, and outcomes information. Outcomes were compared with logistic (observed response rate; ORR) and Cox (progression-free survival; PFS, overall survival; OS) regression between patients with/without metastasis beyond lymph nodes (LN) and those with/without bone/liver/lung metastasis. Analysis was stratified by 1st or 2nd+ line.
RESULTS: We identified 917 ICI-treated patients: in the 1st line, bone/liver metastases were associated with shorter PFS (Hazard ratio; HR: 1.65 and 2.54), OS (HR: 1.60 and 2.35, respectively) and lower ORR (OR: 0.48 and 0.31). In the 2nd+ line, bone/liver metastases were associated with shorter PFS (HR: 1.71 and 1.62), OS (HR: 1.76 and 1.56) and, for bone-only metastases, lower ORR (OR: 0.29). In the 1st line, LN-confined metastasis was associated with longer PFS (HR: 0.53), OS (HR:0.49) and higher ORR (OR: 2.97). In the 2nd+ line, LN-confined metastasis was associated with longer PFS (HR: 0.47), OS (HR: 0.54), and higher ORR (OR: 2.79); all associations were significant.
CONCLUSION: Bone and/or liver metastases were associated with worse, while LN-confined metastases were associated with better outcomes in patients with aUC receiving ICI. These findings in a large population treated outside clinical trials corroborate data from trial subset analyses.