PMID- 34823022
OWN - NLM
STAT- MEDLINE
DCOM- 20220117
LR  - 20220117
IS  - 1879-0461 (Electronic)
IS  - 1040-8428 (Linking)
VI  - 169
DP  - 2022 Jan
TI  - Immuno-oncology therapy in metastatic bladder cancer: A systematic review and 
      network meta-analysis.
PG  - 103534
LID - S1040-8428(21)00321-8 [pii]
LID - 10.1016/j.critrevonc.2021.103534 [doi]
AB  - CONTEXT: Three first line and three second-line clinical trials tested the effect 
      of immunotherapy (IO) relative to standard chemotherapy (CT) on overall survival. 
      However, network meta-analysis-based comparisons have not yet been presented. We 
      addressed this void. OBJECTIVE: To provide comparisons of overall survival (OS), 
      progression-free survival (PFS), complete response (CR), partial response (PR), 
      stable disease (SD), objective response rates (ORR), disease control rates (DCR) 
      and adverse events (AEs) associated with 1st and 2nd line IO-based regimens. 
      MATERIALS AND METHODS: PubMed was searched for phase III randomized controlled 
      trials from 2016 to 2021, including conference abstracts. We identified three 
      first line [IMvigor130 (atezolizumab + CT vs atezolizumab vs CT), DANUBE 
      (durvalumab vs durvalumab + tremelimumab vs CT), and KEYNOTE-361 
      (pembrolizumab + CT vs pembrolizumab vs CT)] and two second line [KEYNOTE-045 
      (pembrolizumab vs CT) and IMvigor211 (atezolizumab vs CT)] RCTs. RESULTS: 
      Overall, 3255 and 1452 patients were respectively included in the first- and 
      second-line settings. In 1st line setting, compared with CT, no IO-based regimen 
      exhibited survival benefit. However, all exclusive IO regimens resulted in lower 
      rates of grade 3+ AEs. In 2nd line setting, compared with CT, only pembrolizumab 
      improved OS benefit. Conversely, atezolizumab only showed OS benefit in 
      exploratory analyses. Compared to second-line CT, no experimental regimen 
      (atezolizumab or pembrolizumab) exhibited statistically significant ORR benefit. 
      Both pembrolizumab and atezolizumab resulted in lower rates of grade 3+ AEs 
      compared to 2nd line CT. CONCLUSIONS: In metastatic UC, IO-based regimens do not 
      hold a survival benefit relative to CT in 1st line setting. However, 
      pembrolizumab holds a survival benefit in 2nd line compared to CT. Several 
      IO-based clinical trials are ongoing and will provide more and possibly better 
      treatment alternatives for locally advanced and metastatic UC.
CI  - Copyright (c) 2021 Elsevier B.V. All rights reserved.
FAU - Chierigo, Francesco
AU  - Chierigo F
AD  - Department of Surgical and Diagnostic Integrated Sciences (DISC), University of 
      Genova, Genova, Italy; Cancer Prognostics and Health Outcomes Unit, Division of 
      Urology, University of Montreal Health Center, Montreal, Quebec, Canada. 
      Electronic address: francesco.chierigo@gmail.com.
FAU - Wenzel, Mike
AU  - Wenzel M
AD  - Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of 
      Montreal Health Center, Montreal, Quebec, Canada; Department of Urology, 
      University Hospital Frankfurt, Frankfurt am Main, Germany.
FAU - Wurnschimmel, Christoph
AU  - Wurnschimmel C
AD  - Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of 
      Montreal Health Center, Montreal, Quebec, Canada; Martini-Klinik Prostate Cancer 
      Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
FAU - Flammia, Rocco Simone
AU  - Flammia RS
AD  - Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of 
      Montreal Health Center, Montreal, Quebec, Canada; Department of Maternal-Child 
      and Urological Sciences, Sapienza Rome University, Policlinico Umberto I 
      Hospital, Rome, Italy.
FAU - Horlemann, Benedikt
AU  - Horlemann B
AD  - Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of 
      Montreal Health Center, Montreal, Quebec, Canada.
FAU - Tian, Zhe
AU  - Tian Z
AD  - Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of 
      Montreal Health Center, Montreal, Quebec, Canada.
FAU - Saad, Fred
AU  - Saad F
AD  - Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of 
      Montreal Health Center, Montreal, Quebec, Canada.
FAU - Chun, Felix K H
AU  - Chun FKH
AD  - Department of Urology, University Hospital Frankfurt, Frankfurt am Main, Germany.
FAU - Tilki, Derya
AU  - Tilki D
AD  - Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, 
      Hamburg, Germany; Department of Urology, University Hospital Hamburg-Eppendorf, 
      Hamburg, Germany.
FAU - Shariat, Shahrokh F
AU  - Shariat SF
AD  - Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, 
      Vienna, Austria; Departments of Urology, Weill Cornell Medical College, New York, 
      NY, USA; Department of Urology, University of Texas Southwestern, Dallas, TX, 
      USA; Department of Urology, Second Faculty of Medicine, Charles University, 
      Prague, Czech Republic; Institute for Urology and Reproductive Health, I.M. 
      Sechenov First Moscow State Medical University, Moscow, Russia; Division of 
      Urology, Department of Special Surgery, Jordan University Hospital, The 
      University of Jordan, Amman, Jordan.
FAU - Gallucci, Michele
AU  - Gallucci M
AD  - Department of Maternal-Child and Urological Sciences, Sapienza Rome University, 
      Policlinico Umberto I Hospital, Rome, Italy.
FAU - Borghesi, Marco
AU  - Borghesi M
AD  - Department of Surgical and Diagnostic Integrated Sciences (DISC), University of 
      Genova, Genova, Italy.
FAU - Suardi, Nazareno
AU  - Suardi N
AD  - Department of Surgical and Diagnostic Integrated Sciences (DISC), University of 
      Genova, Genova, Italy.
FAU - Terrone, Carlo
AU  - Terrone C
AD  - Department of Surgical and Diagnostic Integrated Sciences (DISC), University of 
      Genova, Genova, Italy.
FAU - Karakiewicz, Pierre I
AU  - Karakiewicz PI
AD  - Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of 
      Montreal Health Center, Montreal, Quebec, Canada.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
DEP - 20211122
PL  - Netherlands
TA  - Crit Rev Oncol Hematol
JT  - Critical reviews in oncology/hematology
JID - 8916049
SB  - IM
MH  - Antineoplastic Combined Chemotherapy Protocols
MH  - Humans
MH  - Immunotherapy
MH  - Network Meta-Analysis
MH  - Progression-Free Survival
MH  - *Urinary Bladder Neoplasms
OTO - NOTNLM
OT  - Cancer immunotherapy
OT  - Immuno-oncology
OT  - Immunotherapy (MeSH)
OT  - Metastatic urothelial carcinoma
OT  - Urinary Bladder Neoplasms (MeSH)
EDAT- 2021/11/26 06:00
MHDA- 2022/01/18 06:00
CRDT- 2021/11/25 20:13
PHST- 2021/05/24 00:00 [received]
PHST- 2021/10/16 00:00 [revised]
PHST- 2021/11/15 00:00 [accepted]
PHST- 2021/11/26 06:00 [pubmed]
PHST- 2022/01/18 06:00 [medline]
PHST- 2021/11/25 20:13 [entrez]
AID - S1040-8428(21)00321-8 [pii]
AID - 10.1016/j.critrevonc.2021.103534 [doi]
PST - ppublish
SO  - Crit Rev Oncol Hematol. 2022 Jan;169:103534. doi: 
      10.1016/j.critrevonc.2021.103534. Epub 2021 Nov 22.