PMID- 34238726
OWN - NLM
STAT- MEDLINE
DCOM- 20220228
LR  - 20220531
IS  - 1879-4076 (Electronic)
IS  - 1879-4068 (Linking)
VI  - 13
IP  - 1
DP  - 2022 Jan
TI  - Efficacy and safety of pembrolizumab for older patients with chemoresistant 
      urothelial carcinoma assessed using propensity score matching.
PG  - 88-93
LID - S1879-4068(21)00164-8 [pii]
LID - 10.1016/j.jgo.2021.07.002 [doi]
AB  - BACKGROUND: We used real-world and large-scale data to assess the clinical 
      efficacy and safety of pembrolizumab in older patients with advanced urothelial 
      carcinoma (UC). METHODS: A total of 608 patients who received pembrolizumab for 
      the treatment of chemoresistant UC were retrospectively analyzed. All patients 
      were histologically diagnosed with pure UC. Using propensity score matching (PSM) 
      (ECOG performance status, site of metastasis, hemoglobin level and 
      neutrophil-to-lymphocyte ratio, 1:1 matching), the overall survival (OS) and 
      adverse events (AEs) of patients <75 and >/=75 years old were compared. RESULTS: 
      The median follow-up (IQR) period was 16.1 (9.9-20.5) months. After PSM, there 
      were 215 patients each in the aged <75 years and aged >/=75-year-old groups. The 
      median OS of all patients was estimated to be 10.4 months (95% confidence 
      interval [CI] = 8.8-12.1). After PSM, the median OS was 7.8 months (95% CI = 
      5.2-10.4) in the <75-year-old group and 10.4 months (95% CI = 7.3-13.5) in the 
      >/=75-year-old group (P = 0.186). Any-grade AEs were more frequently reported in 
      the >/=75-year-old group in comparison to the age <75-year-old group (55.3% vs. 
      41.9%, P = 0.007), whereas there was no significant difference between the two 
      groups in the incidence of grade >/=3 AEs (10.2% vs. 12.6%, P = 0.544). The 
      objective response rate, defined as complete remission or a partial response, was 
      22.8% in the <75-year-old group and 25.1% in the >/=75-year-old group (P = 0.651). 
      CONCLUSIONS: The present study demonstrates that age does not affect the efficacy 
      and safety of pembrolizumab treatment for advanced chemoresistant UC. 
      Pembrolizumab treatment should not be avoided based on chronological age; 
      however, close monitoring for the development of treatment-related AE should be 
      considered for older patients.
CI  - Copyright (c) 2021 Elsevier Ltd. All rights reserved.
FAU - Nishiyama, Naotaka
AU  - Nishiyama N
AD  - Department of Urology, Faculty of Medicine, University of Toyama, Toyama, Japan.
FAU - Kobayashi, Takashi
AU  - Kobayashi T
AD  - Department of Urology, Kyoto University Graduate School of Medicine, Kyoto, 
      Japan. Electronic address: selecao@kuhp.kyoto-u.ac.jp.
FAU - Narita, Shintaro
AU  - Narita S
AD  - Department of Urology, Akita University School of Medicine, Akita, Japan.
FAU - Hidaka, Yu
AU  - Hidaka Y
AD  - Department of Biomedical Statistics and Bioinformatics, Kyoto University Graduate 
      School of Medicine, Kyoto, Japan.
FAU - Ito, Katsuhiro
AU  - Ito K
AD  - Department of Urology, Ijinkai Takeda General Hospital, Kyoto, Japan.
FAU - Maruyama, Satoru
AU  - Maruyama S
AD  - Department of Urology, Hokkaido Cancer Center, Sapporo, Japan.
FAU - Mukai, Shoichiro
AU  - Mukai S
AD  - Department of Urology, Miyazaki University, Miyazaki, Japan.
FAU - Tsutsumi, Masakazu
AU  - Tsutsumi M
AD  - Department of Urology, Hitachi General Hospital, Hitachi, Japan.
FAU - Miki, Jun
AU  - Miki J
AD  - Department of Urology, Jikei University Kashiwa Hospital, Kashiwa, Japan.
FAU - Okuno, Tomoya
AU  - Okuno T
AD  - Department of Urology, Shimada Municipal Hospital, Shimada, Japan.
FAU - Yoshio, Yuko
AU  - Yoshio Y
AD  - Department of Urology, Mie University, Tsu, Japan.
FAU - Matsumoto, Hiroaki
AU  - Matsumoto H
AD  - Department of Urology, Yamaguchi University, Ube, Japan.
FAU - Shimazui, Toru
AU  - Shimazui T
AD  - Department of Urology, Ibaraki Prefectural Central Hospital, Kasama, Japan.
FAU - Segawa, Takehiko
AU  - Segawa T
AD  - Department of Urology, Kyoto City Hospital, Kyoto, Japan.
FAU - Karashima, Takashi
AU  - Karashima T
AD  - Department of Urology, Kochi University, Kochi, Japan.
FAU - Masui, Kimihiko
AU  - Masui K
AD  - Department of Urology, Otsu City Hospital, Otsu, Japan.
FAU - Fukuta, Fumimasa
AU  - Fukuta F
AD  - Department of Urology, Sapporo Medical University, Sapporo, Japan.
FAU - Tashiro, Kojiro
AU  - Tashiro K
AD  - Department of Urology, Jikei University School of Medicine, Tokyo, Japan.
FAU - Imai, Kazuto
AU  - Imai K
AD  - Department of Urology, Kansai Electric Power Hospital, Osaka, Japan.
FAU - Suekane, Shigetaka
AU  - Suekane S
AD  - Department of Urology, Kurume University School of Medicine, Kurume, Japan.
FAU - Nagasawa, Seiji
AU  - Nagasawa S
AD  - Department of Urology, Hyogo College of Medicine, Nishinomiya, Japan.
FAU - Higashi, Shin
AU  - Higashi S
AD  - Department of Urology, Hirakata Kohsai Hospital, Hirakata, Japan.
FAU - Fukui, Tomohiro
AU  - Fukui T
AD  - Department of Urology, Rakuwakai Otowa Hospital, Kyoto, Japan.
FAU - Kojima, Takahiro
AU  - Kojima T
AD  - Department of Urology, University of Tsukuba, Tsukuba, Japan.
FAU - Morita, Satoshi
AU  - Morita S
AD  - Department of Biomedical Statistics and Bioinformatics, Kyoto University Graduate 
      School of Medicine, Kyoto, Japan.
FAU - Ogawa, Osamu
AU  - Ogawa O
AD  - Department of Urology, Kyoto University Graduate School of Medicine, Kyoto, 
      Japan.
FAU - Nishiyama, Hiroyuki
AU  - Nishiyama H
AD  - Department of Urology, University of Tsukuba, Tsukuba, Japan.
FAU - Kitamura, Hiroshi
AU  - Kitamura H
AD  - Department of Urology, Faculty of Medicine, University of Toyama, Toyama, Japan.
CN  - Japan Urological Oncology Group
LA  - eng
PT  - Journal Article
DEP - 20210706
PL  - Netherlands
TA  - J Geriatr Oncol
JT  - Journal of geriatric oncology
JID - 101534770
RN  - 0 (Antibodies, Monoclonal, Humanized)
RN  - DPT0O3T46P (pembrolizumab)
SB  - IM
MH  - Aged
MH  - Antibodies, Monoclonal, Humanized/*therapeutic use
MH  - *Carcinoma, Transitional Cell/drug therapy
MH  - Drug Resistance, Neoplasm
MH  - Humans
MH  - Propensity Score
MH  - Retrospective Studies
MH  - *Urinary Bladder Neoplasms/drug therapy
OTO - NOTNLM
OT  - Chemoresistant urothelial carcinoma
OT  - Older patients
OT  - Pembrolizumab
EDAT- 2021/07/10 06:00
MHDA- 2022/03/01 06:00
CRDT- 2021/07/09 05:58
PHST- 2021/04/27 00:00 [received]
PHST- 2021/06/22 00:00 [revised]
PHST- 2021/07/01 00:00 [accepted]
PHST- 2021/07/10 06:00 [pubmed]
PHST- 2022/03/01 06:00 [medline]
PHST- 2021/07/09 05:58 [entrez]
AID - S1879-4068(21)00164-8 [pii]
AID - 10.1016/j.jgo.2021.07.002 [doi]
PST - ppublish
SO  - J Geriatr Oncol. 2022 Jan;13(1):88-93. doi: 10.1016/j.jgo.2021.07.002. Epub 2021 
      Jul 6.