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The efficacy and safety of first-line treatment in cisplatin-ineligible advanced upper tract urothelial carcinoma patients: a comparison of PD-1 inhibitor and carboplatin plus gemcitabine chemotherapy

Although several programmed cell death (PD)-1 inhibitors are approved for the first-line treatment of advanced urothelial carcinoma, their efficacy remains unknown in cisplatin-ineligible patients with upper tract urothelial carcinoma (UTUC) compared with gemcitabine plus carboplatin. Data for patie...

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Autores principales: Huang, Jiwei, Su, Ruopeng, Chen, Zeyu, Jiang, Shuai, Chen, Minfeng, Yuan, Yichu, Hu, Hailong, Fu, Changde, Huang, Zhiyang, Wang, Zhenyu, Zheng, Bing, Li, Chancan, Wang, Zaoyu, Bao, Yige, Cai, Ming, Guo, Jianming, Wei, Qiang, Xue, Wei
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Taylor & Francis 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9487735/
https://www.ncbi.nlm.nih.gov/pubmed/36148322
http://dx.doi.org/10.1080/2162402X.2022.2124691
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author Huang, Jiwei
Su, Ruopeng
Chen, Zeyu
Jiang, Shuai
Chen, Minfeng
Yuan, Yichu
Hu, Hailong
Fu, Changde
Huang, Zhiyang
Wang, Zhenyu
Zheng, Bing
Li, Chancan
Wang, Zaoyu
Bao, Yige
Cai, Ming
Guo, Jianming
Wei, Qiang
Xue, Wei
author_facet Huang, Jiwei
Su, Ruopeng
Chen, Zeyu
Jiang, Shuai
Chen, Minfeng
Yuan, Yichu
Hu, Hailong
Fu, Changde
Huang, Zhiyang
Wang, Zhenyu
Zheng, Bing
Li, Chancan
Wang, Zaoyu
Bao, Yige
Cai, Ming
Guo, Jianming
Wei, Qiang
Xue, Wei
author_sort Huang, Jiwei
collection PubMed
description Although several programmed cell death (PD)-1 inhibitors are approved for the first-line treatment of advanced urothelial carcinoma, their efficacy remains unknown in cisplatin-ineligible patients with upper tract urothelial carcinoma (UTUC) compared with gemcitabine plus carboplatin. Data for patients with UTUC were retrospectively retrieved from the electronic medical records of nine institutions between 2018 and 2021. Patients considered ineligible for cisplatin who received either PD-1 inhibitors (n = 70) or gemcitabine plus carboplatin (n = 53) were included. Efficacy was assessed using Response Evaluation Criteria in Solid Tumors. Median progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan–Meier method. The objective response rate (ORR) was comparable between the PD-1 inhibitor and carboplatin–gemcitabine groups (38.6% versus 41.5%). Median PFS was 5.0 months (95% confidence interval [CI]: 2.0–8.0) in the PD-1 inhibitor group, versus 7.0 months (95% CI: 5.8–8.2) in the carboplatin–gemcitabine group (hazard ratio [HR] = 0.741, 95% CI: 0.485–1.132, p = .166). Median OS was 18 months (95% CI: 4.1–31.9) in the PD-1 inhibitor group, compared with 14 months (95% CI: 12.1–15.9) in the carboplatin–gemcitabine group (HR = 0.731, 95% CI: 0.426–1.256, p = .257). The duration of response was significantly longer in the PD-1 inhibitor group than in the carboplatin–gemcitabine group (not reached vs. 9 months, p < .001). Treatment-related adverse events were less frequent in the PD-1 inhibitor group than in the carboplatin–gemcitabine group (57.1% vs. 77.3%). In conclusion, PD-1 inhibitors displayed promising efficacy with less toxicity and longer DOR in the first-line treatment of UTUC in patients ineligible for cisplatin-based chemotherapy.
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spelling pubmed-94877352022-09-21 The efficacy and safety of first-line treatment in cisplatin-ineligible advanced upper tract urothelial carcinoma patients: a comparison of PD-1 inhibitor and carboplatin plus gemcitabine chemotherapy Huang, Jiwei Su, Ruopeng Chen, Zeyu Jiang, Shuai Chen, Minfeng Yuan, Yichu Hu, Hailong Fu, Changde Huang, Zhiyang Wang, Zhenyu Zheng, Bing Li, Chancan Wang, Zaoyu Bao, Yige Cai, Ming Guo, Jianming Wei, Qiang Xue, Wei Oncoimmunology Original Research Although several programmed cell death (PD)-1 inhibitors are approved for the first-line treatment of advanced urothelial carcinoma, their efficacy remains unknown in cisplatin-ineligible patients with upper tract urothelial carcinoma (UTUC) compared with gemcitabine plus carboplatin. Data for patients with UTUC were retrospectively retrieved from the electronic medical records of nine institutions between 2018 and 2021. Patients considered ineligible for cisplatin who received either PD-1 inhibitors (n = 70) or gemcitabine plus carboplatin (n = 53) were included. Efficacy was assessed using Response Evaluation Criteria in Solid Tumors. Median progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan–Meier method. The objective response rate (ORR) was comparable between the PD-1 inhibitor and carboplatin–gemcitabine groups (38.6% versus 41.5%). Median PFS was 5.0 months (95% confidence interval [CI]: 2.0–8.0) in the PD-1 inhibitor group, versus 7.0 months (95% CI: 5.8–8.2) in the carboplatin–gemcitabine group (hazard ratio [HR] = 0.741, 95% CI: 0.485–1.132, p = .166). Median OS was 18 months (95% CI: 4.1–31.9) in the PD-1 inhibitor group, compared with 14 months (95% CI: 12.1–15.9) in the carboplatin–gemcitabine group (HR = 0.731, 95% CI: 0.426–1.256, p = .257). The duration of response was significantly longer in the PD-1 inhibitor group than in the carboplatin–gemcitabine group (not reached vs. 9 months, p < .001). Treatment-related adverse events were less frequent in the PD-1 inhibitor group than in the carboplatin–gemcitabine group (57.1% vs. 77.3%). In conclusion, PD-1 inhibitors displayed promising efficacy with less toxicity and longer DOR in the first-line treatment of UTUC in patients ineligible for cisplatin-based chemotherapy. Taylor & Francis 2022-09-17 /pmc/articles/PMC9487735/ /pubmed/36148322 http://dx.doi.org/10.1080/2162402X.2022.2124691 Text en © 2022 The Author(s). Published with license by Taylor & Francis Group, LLC. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Research
Huang, Jiwei
Su, Ruopeng
Chen, Zeyu
Jiang, Shuai
Chen, Minfeng
Yuan, Yichu
Hu, Hailong
Fu, Changde
Huang, Zhiyang
Wang, Zhenyu
Zheng, Bing
Li, Chancan
Wang, Zaoyu
Bao, Yige
Cai, Ming
Guo, Jianming
Wei, Qiang
Xue, Wei
The efficacy and safety of first-line treatment in cisplatin-ineligible advanced upper tract urothelial carcinoma patients: a comparison of PD-1 inhibitor and carboplatin plus gemcitabine chemotherapy
title The efficacy and safety of first-line treatment in cisplatin-ineligible advanced upper tract urothelial carcinoma patients: a comparison of PD-1 inhibitor and carboplatin plus gemcitabine chemotherapy
title_full The efficacy and safety of first-line treatment in cisplatin-ineligible advanced upper tract urothelial carcinoma patients: a comparison of PD-1 inhibitor and carboplatin plus gemcitabine chemotherapy
title_fullStr The efficacy and safety of first-line treatment in cisplatin-ineligible advanced upper tract urothelial carcinoma patients: a comparison of PD-1 inhibitor and carboplatin plus gemcitabine chemotherapy
title_full_unstemmed The efficacy and safety of first-line treatment in cisplatin-ineligible advanced upper tract urothelial carcinoma patients: a comparison of PD-1 inhibitor and carboplatin plus gemcitabine chemotherapy
title_short The efficacy and safety of first-line treatment in cisplatin-ineligible advanced upper tract urothelial carcinoma patients: a comparison of PD-1 inhibitor and carboplatin plus gemcitabine chemotherapy
title_sort efficacy and safety of first-line treatment in cisplatin-ineligible advanced upper tract urothelial carcinoma patients: a comparison of pd-1 inhibitor and carboplatin plus gemcitabine chemotherapy
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9487735/
https://www.ncbi.nlm.nih.gov/pubmed/36148322
http://dx.doi.org/10.1080/2162402X.2022.2124691
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