PMID- 33330066
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20231110
IS  - 2234-943X (Print)
IS  - 2234-943X (Electronic)
IS  - 2234-943X (Linking)
VI  - 10
DP  - 2020
TI  - Safety and Efficacy of Immune Checkpoint Inhibitors for Patients With Metastatic 
      Urothelial Carcinoma and End-Stage Renal Disease: Experiences From Real-World 
      Practice.
PG  - 584834
LID - 10.3389/fonc.2020.584834 [doi]
LID - 584834
AB  - BACKGROUND: Immune checkpoint inhibitors (ICIs) are used widely for treating 
      metastatic urothelial carcinoma (mUC). In practical settings, evidence is lacking 
      on the efficacy of ICIs in some difficult-to-treat patients, such as those with 
      end-stage renal disease (ESRD). Herein, we evaluate the safety and efficacy of 
      ICIs for patients with mUC and ESRD. METHODS: For this retrospective study, 
      patients with mUC who were given ICIs at Kaohsiung Chang Gang Memorial Hospital 
      and Linkou Chang Gung Memorial Hospital between April 2016 and November 2019 were 
      consecutively enrolled. All clinicopathologic data, treatment responses, and 
      adverse events were recorded. The immune-related adverse events (AEs), objective 
      response rate (ORR), progression-free survival (PFS), and overall survival (OS) 
      were compared between ESRD and non-ESRD groups. RESULTS: In total, 129 patients 
      with mUC were enrolled, with 11 patients categorized as the ESRD group. Among 
      these patients with ESRD receiving ICIs, 7 of 11 (63.6%) had high-grade (grade 
      >/=3) AEs, chiefly hematologic toxicity. Some rarely encountered AEs were noted, 
      including toxic epidermal necrolysis, tuberculosis reactivation, ascites, and 
      cytokine release syndrome. Patients in the ESRD group had numerically higher ORR 
      (54.5% vs. 28.8%, p = 0.09), PFS (7.1 vs. 3.5 months, p = 0.42), and OS (not 
      reached vs. 15.4 months) than the non-ESRD group. A multivariate Cox regression 
      model demonstrated that leukocytosis (hazard ratio [HR]: 2.63; 95% confidence 
      interval [CI]: 1.23-5.63; p = 0.01) and neutrophil-to-lymphocyte ratio (HR 2.91; 
      95% CI: 1.30-6.53; p = 0.01) were independent prognostic factors. CONCLUSION: 
      Administration of ICIs in patients with mUC and ESRD demonstrated a modest 
      antitumor activity, and should be used with caution for increasing risk of 
      hematologic toxicity.
CI  - Copyright (c) 2020 Kuo, Su, Huang, Luo, Chiu, Li, Wu, Liu, Cheng, Kang and Su.
FAU - Kuo, Ming-Chun
AU  - Kuo MC
AD  - Division of Hematology Oncology, Department of Internal Medicine, Kaohsiung Chang 
      Gung Memorial Hospital and Chang Gung University, College of Medicine, Kaohsiung, 
      Taiwan.
FAU - Su, Po-Jung
AU  - Su PJ
AD  - Division of Hematology Oncology, Chang Gung Memorial Hospital at Linkou and 
      College of Medicine, Chang Gung University, Tao-Yuan, Taiwan.
FAU - Huang, Chun-Chieh
AU  - Huang CC
AD  - Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital and 
      Chang Gung University, College of Medicine, Kaohsiung, Taiwan.
FAU - Luo, Hao-Lun
AU  - Luo HL
AD  - Department of Urology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung 
      University, College of Medicine, Kaohsiung, Taiwan.
FAU - Chiu, Tai-Jan
AU  - Chiu TJ
AD  - Division of Hematology Oncology, Department of Internal Medicine, Kaohsiung Chang 
      Gung Memorial Hospital and Chang Gung University, College of Medicine, Kaohsiung, 
      Taiwan.
FAU - Li, Shau-Hsuan
AU  - Li SH
AD  - Division of Hematology Oncology, Department of Internal Medicine, Kaohsiung Chang 
      Gung Memorial Hospital and Chang Gung University, College of Medicine, Kaohsiung, 
      Taiwan.
FAU - Wu, Chia-Che
AU  - Wu CC
AD  - Division of Hematology Oncology, Department of Internal Medicine, Kaohsiung Chang 
      Gung Memorial Hospital and Chang Gung University, College of Medicine, Kaohsiung, 
      Taiwan.
FAU - Liu, Ting-Ting
AU  - Liu TT
AD  - Department of Pathology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung 
      University, College of Medicine, Kaohsiung, Taiwan.
FAU - Cheng, Yuan-Tso
AU  - Cheng YT
AD  - Department of Urology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung 
      University, College of Medicine, Kaohsiung, Taiwan.
FAU - Kang, Chih-Hsiung
AU  - Kang CH
AD  - Department of Urology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung 
      University, College of Medicine, Kaohsiung, Taiwan.
FAU - Su, Yu-Li
AU  - Su YL
AD  - Division of Hematology Oncology, Department of Internal Medicine, Kaohsiung Chang 
      Gung Memorial Hospital and Chang Gung University, College of Medicine, Kaohsiung, 
      Taiwan.
AD  - Clinical Trial Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
LA  - eng
PT  - Journal Article
DEP - 20201127
PL  - Switzerland
TA  - Front Oncol
JT  - Frontiers in oncology
JID - 101568867
PMC - PMC7729012
OTO - NOTNLM
OT  - end-stage renal disease
OT  - immune checkpoint inhibitor
OT  - metastatic urothelial carcinoma
OT  - safety
OT  - survival
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2020/12/18 06:00
MHDA- 2020/12/18 06:01
PMCR- 2020/01/01
CRDT- 2020/12/17 05:52
PHST- 2020/07/18 00:00 [received]
PHST- 2020/10/29 00:00 [accepted]
PHST- 2020/12/17 05:52 [entrez]
PHST- 2020/12/18 06:00 [pubmed]
PHST- 2020/12/18 06:01 [medline]
PHST- 2020/01/01 00:00 [pmc-release]
AID - 10.3389/fonc.2020.584834 [doi]
PST - epublish
SO  - Front Oncol. 2020 Nov 27;10:584834. doi: 10.3389/fonc.2020.584834. eCollection 
      2020.