• Je něco špatně v tomto záznamu ?

First-line immune-checkpoint inhibitor combination therapy for chemotherapy-eligible patients with metastatic urothelial carcinoma: A systematic review and meta-analysis

K. Mori, B. Pradere, M. Moschini, H. Mostafaei, E. Laukhtina, VM. Schuettfort, R. Sari Motlagh, F. Soria, JYC. Teoh, S. Egawa, T. Powles, SF. Shariat, European Association of Urology–Young Academic Urologists Urothelial Carcinoma Working Group (EAU-YAU)

. 2021 ; 151 (-) : 35-48. [pub] 20210504

Jazyk angličtina Země Velká Británie

Typ dokumentu časopisecké články, metaanalýza, práce podpořená grantem, systematický přehled

Perzistentní odkaz   https://www.medvik.cz/link/bmc22004131

INTRODUCTION: Platinum-based combination chemotherapy is the standard treatment for patients with chemotherapy-eligible metastatic urothelial carcinoma (mUC). Immune-checkpoint inhibitors (ICIs) are currently assessed in this setting. This review aimed to assess the role of ICIs alone or in combination as first-line treatment in chemotherapy-eligible patients with mUC. METHODS: Multiple databases were searched for articles published until November 2020. Studies were deemed eligible if they compared overall survival (OS), progression-free survival (PFS), objective response rates (ORRs), complete response rates (CRRs), durations of response (DORs) and adverse events (AEs) in chemotherapy-eligible patients with mUC. RESULTS: Three studies met our eligibility criteria. ICI combination therapy was associated with significantly better OS and PFS, higher CRR and longer DOR than chemotherapy alone (hazard ratio [HR]: 0.85, 95% confidence interval [CI]: 0.76-0.94, P = 0.002; HR: 0.80, 95% CI: 0.71-0.90, P = 0.0002; odds ratio [OR]: 1.48, 95% CI: 1.12-1.96, P = 0.006; and mean difference: 1.39, 95% CI: 0.31-2.46, P = 0.01, respectively). ICI-chemotherapy combination therapy was also associated with significantly better OS and PFS, higher ORR and CRR and longer DOR than chemotherapy alone. Although OS and PFS benefits of ICI combination therapy were larger in patients with high expression of programmed death-ligand 1 (PD-L1), PD-L1 low expression patients also had a benefit; HR for OS (high PD-L1: HR 0.79 versus low PD-L1: HR 0.89) and PFS (high PD-L1: HR 0.74 versus low PD-L1: HR 0.82). ICI monotherapy was not associated with better oncological outcomes but was associated with better safety outcomes than chemotherapy alone. CONCLUSIONS: Our analysis indicates a superior oncologic benefit to first-line ICI combination therapies in patients with chemotherapy-eligible mUC over standard chemotherapy. In contrast, ICI monotherapy was associated with favorable safety outcomes compared with chemotherapy but failed to show its superiority over chemotherapy in oncological benefits. PD-L1 status alone cannot help guide treatment decision-making. However, caution should be exercised in interpreting the conclusions drawn from this study, given that there is the heterogeneity of the population of interest, risk of bias and the nature of the studies evaluated whose data remain immature or unpublished.

Citace poskytuje Crossref.org

000      
00000naa a2200000 a 4500
001      
bmc22004131
003      
CZ-PrNML
005      
20220127145503.0
007      
ta
008      
220113s2021 xxk f 000 0|eng||
009      
AR
024    7_
$a 10.1016/j.ejca.2021.03.049 $2 doi
035    __
$a (PubMed)33962359
040    __
$a ABA008 $b cze $d ABA008 $e AACR2
041    0_
$a eng
044    __
$a xxk
100    1_
$a Mori, Keiichiro $u Department of Urology, Medical University of Vienna, Vienna, Austria; Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
245    10
$a First-line immune-checkpoint inhibitor combination therapy for chemotherapy-eligible patients with metastatic urothelial carcinoma: A systematic review and meta-analysis / $c K. Mori, B. Pradere, M. Moschini, H. Mostafaei, E. Laukhtina, VM. Schuettfort, R. Sari Motlagh, F. Soria, JYC. Teoh, S. Egawa, T. Powles, SF. Shariat, European Association of Urology–Young Academic Urologists Urothelial Carcinoma Working Group (EAU-YAU)
520    9_
$a INTRODUCTION: Platinum-based combination chemotherapy is the standard treatment for patients with chemotherapy-eligible metastatic urothelial carcinoma (mUC). Immune-checkpoint inhibitors (ICIs) are currently assessed in this setting. This review aimed to assess the role of ICIs alone or in combination as first-line treatment in chemotherapy-eligible patients with mUC. METHODS: Multiple databases were searched for articles published until November 2020. Studies were deemed eligible if they compared overall survival (OS), progression-free survival (PFS), objective response rates (ORRs), complete response rates (CRRs), durations of response (DORs) and adverse events (AEs) in chemotherapy-eligible patients with mUC. RESULTS: Three studies met our eligibility criteria. ICI combination therapy was associated with significantly better OS and PFS, higher CRR and longer DOR than chemotherapy alone (hazard ratio [HR]: 0.85, 95% confidence interval [CI]: 0.76-0.94, P = 0.002; HR: 0.80, 95% CI: 0.71-0.90, P = 0.0002; odds ratio [OR]: 1.48, 95% CI: 1.12-1.96, P = 0.006; and mean difference: 1.39, 95% CI: 0.31-2.46, P = 0.01, respectively). ICI-chemotherapy combination therapy was also associated with significantly better OS and PFS, higher ORR and CRR and longer DOR than chemotherapy alone. Although OS and PFS benefits of ICI combination therapy were larger in patients with high expression of programmed death-ligand 1 (PD-L1), PD-L1 low expression patients also had a benefit; HR for OS (high PD-L1: HR 0.79 versus low PD-L1: HR 0.89) and PFS (high PD-L1: HR 0.74 versus low PD-L1: HR 0.82). ICI monotherapy was not associated with better oncological outcomes but was associated with better safety outcomes than chemotherapy alone. CONCLUSIONS: Our analysis indicates a superior oncologic benefit to first-line ICI combination therapies in patients with chemotherapy-eligible mUC over standard chemotherapy. In contrast, ICI monotherapy was associated with favorable safety outcomes compared with chemotherapy but failed to show its superiority over chemotherapy in oncological benefits. PD-L1 status alone cannot help guide treatment decision-making. However, caution should be exercised in interpreting the conclusions drawn from this study, given that there is the heterogeneity of the population of interest, risk of bias and the nature of the studies evaluated whose data remain immature or unpublished.
650    _2
$a dospělí $7 D000328
650    _2
$a senioři $7 D000368
650    _2
$a senioři nad 80 let $7 D000369
650    _2
$a protokoly protinádorové kombinované chemoterapie $x škodlivé účinky $x terapeutické užití $7 D000971
650    _2
$a antigeny CD274 $x antagonisté a inhibitory $7 D060890
650    _2
$a karcinom $x farmakoterapie $x imunologie $x mortalita $x patologie $7 D002277
650    _2
$a klinické rozhodování $7 D000066491
650    _2
$a ženské pohlaví $7 D005260
650    _2
$a lidé $7 D006801
650    _2
$a inhibitory kontrolních bodů $x škodlivé účinky $x terapeutické užití $7 D000082082
650    _2
$a mužské pohlaví $7 D008297
650    _2
$a lidé středního věku $7 D008875
650    _2
$a výběr pacientů $7 D018579
650    _2
$a doba přežití bez progrese choroby $7 D000077982
650    _2
$a časové faktory $7 D013997
650    _2
$a nádory močového měchýře $x farmakoterapie $x imunologie $x mortalita $x patologie $7 D001749
650    _2
$a urotel $x účinky léků $x imunologie $x patologie $7 D019459
655    _2
$a časopisecké články $7 D016428
655    _2
$a metaanalýza $7 D017418
655    _2
$a práce podpořená grantem $7 D013485
655    _2
$a systematický přehled $7 D000078182
700    1_
$a Pradere, Benjamin $u Department of Urology, Medical University of Vienna, Vienna, Austria
700    1_
$a Moschini, Marco $u Klinik für Urologie, Luzerner Kantonsspital, Lucerne, Switzerland
700    1_
$a Mostafaei, Hadi $u Department of Urology, Medical University of Vienna, Vienna, Austria; Research Center for Evidence Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
700    1_
$a Laukhtina, Ekaterina $u Department of Urology, Medical University of Vienna, Vienna, Austria; Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
700    1_
$a Schuettfort, Victor M $u Department of Urology, Medical University of Vienna, Vienna, Austria; Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
700    1_
$a Sari Motlagh, Reza $u Department of Urology, Medical University of Vienna, Vienna, Austria; Men's Health and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
700    1_
$a Soria, Francesco $u Division of Urology, Department of Surgical Sciences, University of Studies of Torino, Turin, Italy
700    1_
$a Teoh, Jeremy Y C $u Department of Surgery, S.H. Ho Urology Centre, The Chinese University of Hong Kong, Hong Kong, China
700    1_
$a Egawa, Shin $u Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
700    1_
$a Powles, Thomas $u Centre for Experimental Cancer Medicine, Barts Cancer Institute, Queen Mary University of London, London, UK
700    1_
$a Shariat, Shahrokh F $u Department of Urology, Medical University of Vienna, Vienna, Austria; Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia; Research Division of Urology, Department of Special Surgery, The University of Jordan, Amman, Jordan; Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA; Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic; Department of Urology, Weill Cornell Medical College, New York, NY, USA; Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria; European Association of Urology Research Foundation, Arnhem, Netherlands. Electronic address: shahrokh.shariat@meduniwien.ac.at
710    2_
$a European Association of Urology–Young Academic Urologists Urothelial Carcinoma Working Group (EAU-YAU)
773    0_
$w MED00009626 $t European journal of cancer (Oxford, England : 1990) $x 1879-0852 $g Roč. 151, č. - (2021), s. 35-48
856    41
$u https://pubmed.ncbi.nlm.nih.gov/33962359 $y Pubmed
910    __
$a ABA008 $b sig $c sign $y p $z 0
990    __
$a 20220113 $b ABA008
991    __
$a 20220127145459 $b ABA008
999    __
$a ok $b bmc $g 1751561 $s 1155280
BAS    __
$a 3
BAS    __
$a PreBMC
BMC    __
$a 2021 $b 151 $c - $d 35-48 $e 20210504 $i 1879-0852 $m European journal of cancer $n Eur J Cancer $x MED00009626
LZP    __
$a Pubmed-20220113

Najít záznam

Citační ukazatele

Pouze přihlášení uživatelé

Možnosti archivace