PMID- 34424218
OWN - NLM
STAT- MEDLINE
DCOM- 20220201
LR  - 20220201
IS  - 1945-4589 (Electronic)
IS  - 1945-4589 (Linking)
VI  - 13
IP  - 16
DP  - 2021 Aug 23
TI  - The efficacy and safety of PD-1/PD-L1 immune checkpoint inhibitors in treating 
      advanced urothelial cancer: a meta-analysis of clinical trials.
PG  - 20468-20480
LID - 10.18632/aging.203429 [doi]
AB  - Survival outcomes in advanced urothelial cancer (UC) are dismal. Over the past 
      years, immunotherapy remains an evolving treatment modality for these patients. 
      This meta-analysis was performed to comprehensively evaluate the efficacy and 
      safety of immune checkpoint inhibitors. For this purpose, 18 clinical trials 
      comprising a total of 3,144 patients were identified from the PubMed database up 
      to September 2020. Overall, the objective response rate (ORR) to PD-1/PD-L1 
      inhibitors was 0.20 [95% confidence intervals (CI) 0.17-0.23]. Furthermore, the 
      pooled 1-year overall survival (OS) and 1-year progression-free survival (PFS) 
      rates were 0.43 (95% CI 0.33-0.53) and 0.19 (95% CI 0.17-0.21), respectively. The 
      summary rates of any-grade and grade >/=3 adverse events (AEs) were 0.66 (95% CI 
      0.58-0.74) and 0.13 (95% CI 0.09-0.18), respectively. Among the different 
      subgroups, PD-1/PD-L1 inhibitors elicited a promising ORR in patients with lymph 
      node-only metastasis compared to those with visceral metastasis (0.41 VS. 0.17). 
      Additionally, patients with primary tumor in the lower tract had higher ORR 
      compared to those with primary tumor in the upper tract (0.24 VS. 0.15). Briefly 
      speaking, this immunotherapy protocol showed an encouraging efficacy and 
      acceptable safety profile in the treatment of advanced UC. Moreover, our findings 
      provided potential clinical significance for patients with lymph node-only 
      metastasis or primary tumor in the lower tract. However, these exciting findings 
      need further confirmation.
FAU - Li, Fei
AU  - Li F
AD  - Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, 
      Guangdong 510515, PR China.
FAU - Wang, Yu
AU  - Wang Y
AD  - Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, 
      Guangdong 510515, PR China.
FAU - Xie, Kunfeng
AU  - Xie K
AD  - Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, 
      Guangdong 510515, PR China.
FAU - Fang, Yunze
AU  - Fang Y
AD  - Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, 
      Guangdong 510515, PR China.
FAU - Du, Yuejun
AU  - Du Y
AD  - Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, 
      Guangdong 510515, PR China.
FAU - Hou, Lina
AU  - Hou L
AD  - Department of Healthy Management, Nanfang Hospital, Southern Medical University, 
      Guangzhou, Guangdong 510515, PR China.
FAU - Tan, Wanlong
AU  - Tan W
AD  - Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, 
      Guangdong 510515, PR China.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
DEP - 20210823
PL  - United States
TA  - Aging (Albany NY)
JT  - Aging
JID - 101508617
RN  - 0 (B7-H1 Antigen)
RN  - 0 (Immune Checkpoint Inhibitors)
RN  - 0 (Programmed Cell Death 1 Receptor)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - B7-H1 Antigen/genetics/*immunology
MH  - Female
MH  - Humans
MH  - Immune Checkpoint Inhibitors/*administration & dosage
MH  - *Immunotherapy
MH  - Male
MH  - Middle Aged
MH  - Programmed Cell Death 1 Receptor/genetics/*immunology
MH  - Progression-Free Survival
MH  - Randomized Controlled Trials as Topic
MH  - Treatment Outcome
MH  - Urinary Bladder Neoplasms/genetics/immunology/mortality/*therapy
PMC - PMC8436906
OTO - NOTNLM
OT  - efficacy
OT  - immunotherapy
OT  - meta-analysis
OT  - safety
OT  - urothelial cancer
COIS- CONFLICTS OF INTEREST: The authors declare no conflicts of interest related to 
      this study.
EDAT- 2021/08/24 06:00
MHDA- 2022/02/02 06:00
PMCR- 2021/08/31
CRDT- 2021/08/23 12:20
PHST- 2020/12/01 00:00 [received]
PHST- 2021/05/10 00:00 [accepted]
PHST- 2021/08/24 06:00 [pubmed]
PHST- 2022/02/02 06:00 [medline]
PHST- 2021/08/23 12:20 [entrez]
PHST- 2021/08/31 00:00 [pmc-release]
AID - 203429 [pii]
AID - 10.18632/aging.203429 [doi]
PST - ppublish
SO  - Aging (Albany NY). 2021 Aug 23;13(16):20468-20480. doi: 10.18632/aging.203429. 
      Epub 2021 Aug 23.