PMID- 37909969
OWN - NLM
STAT- MEDLINE
DCOM- 20231102
LR  - 20231102
IS  - 1791-7530 (Electronic)
IS  - 0250-7005 (Linking)
VI  - 43
IP  - 11
DP  - 2023 Nov
TI  - Second-line Pembrolizumab for Metastatic Urothelial Carcinoma: Differences in 
      Treatment Outcomes According to the Primary Site.
PG  - 5041-5050
LID - 10.21873/anticanres.16703 [doi]
AB  - BACKGROUND/AIM: To evaluate the difference in the clinical efficacy and safety of 
      pembrolizumab between patients with metastatic upper tract urothelial carcinoma 
      (UTUC), which includes renal pelvic urothelial carcinoma (UC) and ureteral UC, 
      and those with metastatic lower tract urothelial carcinoma (LTUC). PATIENTS AND 
      METHODS: A total of 752 patients who received pembrolizumab for the treatment of 
      chemoresistant UC were retrospectively analyzed. We compared progression-free 
      survival (PFS), overall survival (OS) and adverse events (AEs) in patients with 
      renal pelvic UC, ureteral UC, and LTUC. RESULTS: The median follow-up period was 
      42.5 [interquartile range (IQR)=35.1-47.4] months. The primary tumor site was in 
      the upper tract in 362 (48.1%) patients [renal pelvis, n=219 (60.5%); ureter, 
      n=143 (39.5%)] and in the lower tract in 390 (51.9%) patients. The estimated 
      glomerular filtration rate before pembrolizumab treatment in the UTUC group was 
      significantly lower than that in the LTUC group (p<0.001). The median PFS in the 
      UTUC and LTUC groups was 3.4 months, respectively (p=0.271). The median OS in the 
      UTUC and LTUC groups was 10.1 months and 11.7 months, respectively (p=0.195). In 
      an analysis of UTUC divided into renal pelvic UC, ureteral UC, and LTUC, patients 
      with renal pelvic UC had a significantly poorer prognosis in comparison to the 
      other two groups (p=0.041). The incidence of any-grade AEs (51.7% vs. 47.9%, 
      p=0.343) and grade >/=3 AEs (12.2% vs. 12.8%, p=0.826) in the two groups was not 
      statistically significantly different. CONCLUSION: No significant differences 
      were found between the UTUC and LTUC groups with regard to the oncological 
      outcomes and safety of pembrolizumab. Patients with renal pelvic UC had a 
      significantly poorer prognosis than those with other ureteral UCs and LTUCs.
CI  - Copyright (c) 2023 International Institute of Anticancer Research (Dr. George J. 
      Delinasios), All rights reserved.
FAU - Nishiyama, Naotaka
AU  - Nishiyama N
AD  - Department of Urology, Faculty of Medicine, University of Toyama, Toyama, Japan.
FAU - Kita, Yuki
AU  - Kita Y
AD  - Department of Urology, Kyoto University Graduate School of Medicine, Kyoto, 
      Japan.
FAU - Ito, Katsuhiro
AU  - Ito K
AD  - Department of Urology, Kyoto University Graduate School of Medicine, Kyoto, 
      Japan.
FAU - Kato, Minoru
AU  - Kato M
AD  - Department of Urology, Osaka Metropolitan University, Osaka, Japan.
FAU - Hatakeyama, Shingo
AU  - Hatakeyama S
AD  - Department of Urology, Hirosaki University, Aomori, Japan.
FAU - Matsushita, Yuto
AU  - Matsushita Y
AD  - Department of Urology, Hamamatsu University School of Medicine, Shizuoka, Japan.
FAU - Naito, Sei
AU  - Naito S
AD  - Department of Urology, Yamagata University Faculty of Medicine, Yamagata, Japan.
FAU - Miyake, Makito
AU  - Miyake M
AD  - Department of Urology, Nara Medical University, Nara, Japan.
FAU - Nakanishi, Shotaro
AU  - Nakanishi S
AD  - Department of Urology, University of the Ryukyus, Okinawa, Japan.
FAU - Kato, Yoichiro
AU  - Kato Y
AD  - Department of Urology, Iwate Medical University, Iwate, Japan.
FAU - Shibuya, Tadamasa
AU  - Shibuya T
AD  - Department of Urology, Oita University, Oita, Japan.
FAU - Hayashi, Tetsutaro
AU  - Hayashi T
AD  - Department of Urology, Hiroshima University, Hiroshima, Japan.
FAU - Yasumoto, Hiroaki
AU  - Yasumoto H
AD  - Department of Urology, Shimane University, Shimane, Japan.
FAU - Yoshida, Takashi
AU  - Yoshida T
AD  - Department of Urology and Andrology, Kansai Medical University, Osaka, Japan.
FAU - Uemura, Motohide
AU  - Uemura M
AD  - Department of Urology, Osaka University, Osaka, Japan.
FAU - Taoka, Rikiya
AU  - Taoka R
AD  - Department of Urology, Kagawa University, Kagawa, Japan.
FAU - Nishiyama, Hiroyuki
AU  - Nishiyama H
AD  - Department of Urology, University of Tsukuba, Tsukuba, Japan.
FAU - Kobayashi, Takashi
AU  - Kobayashi T
AD  - Department of Urology, Kyoto University Graduate School of Medicine, Kyoto, 
      Japan; selecao@kuhp.kyoto-u.ac.jp.
FAU - Kitamura, Hiroshi
AU  - Kitamura H
CN  - Japan Urological Oncology Group
LA  - eng
PT  - Journal Article
PL  - Greece
TA  - Anticancer Res
JT  - Anticancer research
JID - 8102988
RN  - DPT0O3T46P (pembrolizumab)
SB  - IM
MH  - Humans
MH  - *Carcinoma, Transitional Cell/drug therapy
MH  - *Urinary Bladder Neoplasms
MH  - Retrospective Studies
MH  - Treatment Outcome
MH  - *Kidney Neoplasms/drug therapy
MH  - *Ureteral Neoplasms
OTO - NOTNLM
OT  - Chemo-resistant urothelial carcinoma
OT  - lower tract urothelial carcinoma
OT  - pembrolizumab
OT  - upper tract urothelial carcinoma
EDAT- 2023/11/01 12:44
MHDA- 2023/11/02 12:42
CRDT- 2023/11/01 10:44
PHST- 2023/07/19 00:00 [received]
PHST- 2023/09/13 00:00 [revised]
PHST- 2023/09/14 00:00 [accepted]
PHST- 2023/11/02 12:42 [medline]
PHST- 2023/11/01 12:44 [pubmed]
PHST- 2023/11/01 10:44 [entrez]
AID - 43/11/5041 [pii]
AID - 10.21873/anticanres.16703 [doi]
PST - ppublish
SO  - Anticancer Res. 2023 Nov;43(11):5041-5050. doi: 10.21873/anticanres.16703.