转移性尿路上皮癌阿维列单抗转换维持治疗的经验和预后分析。

IF 2.5 3区 医学 Q3 ONCOLOGY
Oncology Pub Date : 2024-07-17 DOI:10.1159/000539795
Teruki Isobe, Taku Naiki, Yosuke Sugiyama, Aya Naiki-Ito, Takashi Nagai, Toshiki Etani, Keitaro Iida, Yusuke Noda, Nobuhiko Shimizu, Maria Aoki, Masakazu Gonda, Toshiharu Morikawa, Rika Banno, Hiroki Kubota, Ryosuke Ando, Noriyasu Kawai, Takahiro Yasui
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引用次数: 0

摘要

简介阿维列单抗被批准用于转移性尿路上皮癌(mUC)的维持治疗,并可延长总生存期(OS)。我们探讨了阿维单抗治疗mUC患者的相关趋势:分析了我们附属医院从 2019 年 1 月至 2022 年 11 月接受一线化疗的 72 例 mUC 患者。我们比较了因一线化疗期间病情进展而接受阿维列单抗治疗的患者(Ave;n=43)和未接受治疗的患者(Ave-untreated;n=29)的临床参数和预后。在接受过阿韦利单抗治疗的患者中,我们将对阿韦利单抗维持治疗有完全或部分应答或最佳应答时病情稳定的患者列为阿韦利单抗(Ave)适用患者;并对这些患者进行了回顾性分析。评估了潜在的预后因素,包括用于确定患者是否适合使用阿维鲁单抗的老年营养风险指数(GNRI):结果:开始一线治疗时,两组患者的基本临床参数无统计学差异。适合接受爱维治疗组(中位 26.6 个月,95% 置信区间[CI]:19.4-未达标[NR])的一线治疗后中位 OS 明显长于未接受爱维治疗组(中位 12.0 个月,95% 置信区间[CI]:7.5-未达标[NR]),且不良反应可耐受。预后因素的临界值由接收者操作特征曲线确定。在单变量和多变量分析中,低年龄和GNRI持续性被认为是阿韦鲁单抗适合的重要预后因素:结论:在mUC中,阿维单抗维持治疗可在可耐受的安全性范围内延长患者的OS。GNRI的持续性可作为预测是否适合使用Ave的生物标志物。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Experience and Prognostic Analysis with Avelumab Switch Maintenance Treatment in Metastatic Urothelial Carcinoma.

Introduction: Avelumab (Ave) is approved for metastatic urothelial carcinoma (mUC) maintenance therapy and prolongs overall survival (OS). We explored trends related to Ave treatment of mUC patients.

Methods: A total of 72 patients with mUC treated with first-line chemotherapy, from January 2019 to November 2022, at our affiliated institutions, were analyzed. We compared clinical parameters and the prognosis of patients treated with Ave (n = 43) because of progression during first-line chemotherapy, with untreated patients (Ave-untreated; n = 29). Among the Ave-treated group, we classified patients showing a complete or partial response or stable disease in their best response to Ave maintenance therapy as Ave-suitable patients; these were retrospectively analyzed. Potential prognostic factors, including the Geriatric Nutritional Risk Index (GNRI) for determining patients suitable for Ave, were evaluated.

Results: The basic clinical parameters of patients when first-line treatment was initiated were not statistically different between the two groups. The Ave-suitable group (median 26.6 months, 95% confidence interval [CI]: 19.4-not reached [NR]) showed significantly longer median OS after first-line treatment than the Ave-untreated group (median 12.0 months, 95% CI: 7.5-NR) with tolerable adverse events. The cut-off values of prognostic factors were set by the receiver operating characteristic curve. Low age and GNRI sustainability were revealed as significant prognostic factors for being Ave-suitable both in univariate and multivariate analysis.

Conclusion: In mUC, Ave maintenance prolonged OS within tolerable safety profiles. GNRI sustainability may be used as a biomarker to predict being Ave-suitable.

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来源期刊
Oncology
Oncology 医学-肿瘤学
CiteScore
6.00
自引率
2.90%
发文量
76
审稿时长
6-12 weeks
期刊介绍: Although laboratory and clinical cancer research need to be closely linked, observations at the basic level often remain removed from medical applications. This journal works to accelerate the translation of experimental results into the clinic, and back again into the laboratory for further investigation. The fundamental purpose of this effort is to advance clinically-relevant knowledge of cancer, and improve the outcome of prevention, diagnosis and treatment of malignant disease. The journal publishes significant clinical studies from cancer programs around the world, along with important translational laboratory findings, mini-reviews (invited and submitted) and in-depth discussions of evolving and controversial topics in the oncology arena. A unique feature of the journal is a new section which focuses on rapid peer-review and subsequent publication of short reports of phase 1 and phase 2 clinical cancer trials, with a goal of insuring that high-quality clinical cancer research quickly enters the public domain, regardless of the trial’s ultimate conclusions regarding efficacy or toxicity.
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