Mp53-10 Site-Specific Metastases Predicting Duration Response to Pembrolizumab in Metastatic Urothelial Carcinoma

You have accessJournal of UrologyBladder Cancer: Invasive V (MP53)1 May 2024MP53-10 SITE-SPECIFIC METASTASES PREDICTING DURATION RESPONSE TO PEMBROLIZUMAB IN METASTATIC UROTHELIAL CARCINOMA Satoshi Katayama, Takehiro Iwata, Tatsushi Kawada, Yusuke Tominaga, Takuya Sadahira, Shingo Nishimura, Kohei Edamura, Kensuke Bekku, Tomoko Kobayashi, Yasuyuki Kobayashi, and Motoo Araki Satoshi KatayamaSatoshi Katayama , Takehiro IwataTakehiro Iwata , Tatsushi KawadaTatsushi Kawada , Yusuke TominagaYusuke Tominaga , Takuya SadahiraTakuya Sadahira , Shingo NishimuraShingo Nishimura , Kohei EdamuraKohei Edamura , Kensuke BekkuKensuke Bekku , Tomoko KobayashiTomoko Kobayashi , Yasuyuki KobayashiYasuyuki Kobayashi , and Motoo ArakiMotoo Araki View All Author Informationhttps://doi.org/10.1097/01.JU.0001008784.37684.bd.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Duration of response has gained attention as a new surrogate endpoint compared with conventional surrogates (objective response rate or progression-free survival) in the era of immune-checkpoint inhibitors. As such, the identification of factors predicting durable response (DR) is of great interest to clinicians. We aimed to assess factors predicting DR in patients with metastatic urothelial carcinoma (mUC) treated with pembrolizumab. METHODS: In this retrospective multi-institutional study, mUC patients who received 2nd-line pembrolizumab were included. DR was defined as the absence of progression/death at any point after the administration of pembrolizumab. Logistic regression analyses were used to assess factors associated with DR. Cox proportional hazards regression analyses were used to assess survival outcomes. Additionally, sensitivity analysis limiting patients who achieved a partial or complete response to pembrolizumab was performed. RESULTS: Of 365 patients included in this study, 80 mUC patients (22%) showed DR at a median follow-up of 8.6 months. Sixty-one (76%) and 40 (14%) patients with and without DR achieved an objective response, respectively (p<0.001). Duration of response in patients with and without DR was 18.0 and 6.4 months, respectively (Figure 1). Multivariable analyses revealed that lymph node metastasis only was associated with an increased probability of DR (OR 2.51; 95%CI 1.46-4.31; p=0.001);meanwhile, liver metastasis was associated with a decreased probability of DR (OR 0.18; 95%CI 1.46-4.31; p=0.001) (Table 1). These findings were also confirmed in the sensitivity analyses. The inclusion of lymph node metastasis and liver metastasis increased the discrimination of a multivariable predctive model by 9.1%. In addition to these predictive factors, better ECOG-PS (≤1) and lower T stage were associated with longer OS and CSS. CONCLUSIONS: Lymph node metastasis only and the absence of liver metastasis were predictors for DR in mUC patients receiving pembrolizumab. Meanwhile, ECOG-PS and T stage had prognostic values but not predictive for the response to pembrolizumab therapy, probably reflecting clinically aggressive tumors independent of treatment regimen. These findings may help determine the timing of transition to 2nd-line pembrolizumab therapy for each patient. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e866 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Satoshi Katayama More articles by this author Takehiro Iwata More articles by this author Tatsushi Kawada More articles by this author Yusuke Tominaga More articles by this author Takuya Sadahira More articles by this author Shingo Nishimura More articles by this author Kohei Edamura More articles by this author Kensuke Bekku More articles by this author Tomoko Kobayashi More articles by this author Yasuyuki Kobayashi More articles by this author Motoo Araki More articles by this author Expand All Advertisement PDF downloadLoading ...