PMID- 38423657
OWN - NLM
STAT- MEDLINE
DCOM- 20240304
LR  - 20240304
IS  - 1791-7530 (Electronic)
IS  - 0250-7005 (Linking)
VI  - 44
IP  - 3
DP  - 2024 Mar
TI  - Comparison of Oncological Outcomes of Pembrolizumab as Second-line Therapy and 
      Maintenance Avelumab Therapy in Advanced Urothelial Carcinoma After 
      Platinum-based Chemotherapy.
PG  - 1271-1279
LID - 10.21873/anticanres.16922 [doi]
AB  - BACKGROUND/AIM: Sequential therapy using chemotherapy and subsequent immune 
      checkpoint inhibitor (ICI) treatment prolongs the survival of patients with 
      advanced urothelial carcinoma (UC). However, no comparison data for oncological 
      outcome between pembrolizumab and avelumab has been reported. Thus, we compared 
      oncological outcomes between pembrolizumab as second-line therapy and maintenance 
      avelumab therapy in patients with advanced UC. PATIENTS AND METHODS: We 
      retrospectively evaluated patients with advanced UC treated with pembrolizumab or 
      avelumab between January 2018 and February 2023. We compared oncological outcomes 
      after adjusting for patient characteristics. Immune-related adverse events (AEs) 
      in each group were evaluated using the Common Terminology Criteria for Adverse 
      Events. RESULTS: There were 186 and 44 patients in the pembrolizumab- and 
      avelumab-treated cohorts, respectively. After propensity score matching, 43 
      patients from each group were selected and analyzed. Median progression-free 
      survival from the initiation of pembrolizumab and avelumab treatments was 126 and 
      139 days, respectively (log-rank test, p=0.625). Median overall survival in the 
      pembrolizumab and avelumab cohorts were 658 days and not reached, respectively 
      (log-rank test, p=0.249). Thirty-eight (20.4%) and 14 (31.8%) all-grade 
      immune-related AEs were observed in 186 pembrolizumab- and 44 avelumab-treated 
      patients, respectively (chi-squared test, p=0.112). Regarding endocrine-related 
      AEs, 12 (6.5%) and none (0%) were observed in pembrolizumab- and avelumab-treated 
      patients, respectively (Fisher's exact probability test, p=0.129). CONCLUSION: 
      Pembrolizumab and maintenance avelumab therapy provide equivalent oncological 
      outcomes in patients with advanced UC. Although no significant difference was 
      observed, there might be a potential risk of higher endocrine-related AEs due to 
      pembrolizumab compared to avelumab maintenance therapy.
CI  - Copyright (c) 2024 International Institute of Anticancer Research (Dr. George J. 
      Delinasios), All rights reserved.
FAU - Shindo, Tetsuya
AU  - Shindo T
AD  - Department of Urology, Sapporo Medical University School of Medicine, Sapporo, 
      Japan; shindo1013@yahoo.co.jp.
FAU - Hashimoto, Kohei
AU  - Hashimoto K
AD  - Department of Urology, Sapporo Medical University School of Medicine, Sapporo, 
      Japan.
FAU - Takahashi, Atsushi
AU  - Takahashi A
AD  - Department of Urology, Hakodate Goryoukaku Hospital, Hakodate, Japan.
FAU - Miyamoto, Shintaro
AU  - Miyamoto S
AD  - Department of Urology, Japanese Red Cross Asahikawa Hospital, Asahikawa, Japan.
FAU - Kunishima, Yasuharu
AU  - Kunishima Y
AD  - Department of Urology, Sunagawa City Medical Center, Sunagawa, Japan.
FAU - Sato, Shunsuke
AU  - Sato S
AD  - Department of Urology, Oji General Hospital, Tomakomai, Japan.
FAU - Fukuta, Fumimasa
AU  - Fukuta F
AD  - Department of Urology, Steel Memorial Muroran Hospital, Muroran, Japan.
FAU - Hiyama, Yoshiki
AU  - Hiyama Y
AD  - Department of Urology, NTT Medical Center Sapporo, Sapporo, Japan.
FAU - Takayanagi, Akio
AU  - Takayanagi A
AD  - Department of Urology, Japan Community Healthcare Organization Hokkaido Hospital, 
      Sapporo, Japan.
FAU - Kato, Ryuichi
AU  - Kato R
AD  - Department of Urology, Muroran City General Hospital, Muroran, Japan.
FAU - Wanifuchi, Atsushi
AU  - Wanifuchi A
AD  - Department of Urology, Japanese Red Cross Kushiro Hospital, Kushiro, Japan.
FAU - Ueki, Yohei
AU  - Ueki Y
AD  - Department of Urology, Takikawa Municipal Hospital, Takikawa, Japan.
FAU - Okada, Manabu
AU  - Okada M
AD  - Department of Urology, Obihiro Kyokai Hospital, Obihiro, Japan.
FAU - Adachi, Hideki
AU  - Adachi H
AD  - Department of Urology, Saiseikai Otaru Hospital, Otaru, Japan.
FAU - Kobayashi, K O
AU  - Kobayashi KO
AD  - Department of Urology, Sapporo Medical University School of Medicine, Sapporo, 
      Japan.
FAU - Tanaka, Toshiaki
AU  - Tanaka T
AD  - Department of Urology, Sapporo Medical University School of Medicine, Sapporo, 
      Japan.
FAU - Masumori, Naoya
AU  - Masumori N
CN  - Sapporo Medical University Urologic Oncology Consortium
LA  - eng
PT  - Journal Article
PL  - Greece
TA  - Anticancer Res
JT  - Anticancer research
JID - 8102988
RN  - DPT0O3T46P (pembrolizumab)
RN  - KXG2PJ551I (avelumab)
RN  - 49DFR088MY (Platinum)
RN  - 0 (Antineoplastic Agents, Immunological)
RN  - 0 (Antibodies, Monoclonal, Humanized)
SB  - IM
MH  - Humans
MH  - *Carcinoma, Transitional Cell/drug therapy
MH  - *Urinary Bladder Neoplasms/drug therapy/pathology
MH  - Platinum/therapeutic use
MH  - Retrospective Studies
MH  - *Urologic Neoplasms/pathology
MH  - *Antineoplastic Agents, Immunological/therapeutic use
MH  - *Antibodies, Monoclonal, Humanized
OTO - NOTNLM
OT  - Advanced urothelial carcinoma
OT  - avelumab
OT  - pembrolizumab
OT  - propensity score match
EDAT- 2024/03/01 01:22
MHDA- 2024/03/04 06:44
CRDT- 2024/02/29 20:53
PHST- 2023/11/15 00:00 [received]
PHST- 2023/12/03 00:00 [revised]
PHST- 2023/12/04 00:00 [accepted]
PHST- 2024/03/04 06:44 [medline]
PHST- 2024/03/01 01:22 [pubmed]
PHST- 2024/02/29 20:53 [entrez]
AID - 44/3/1271 [pii]
AID - 10.21873/anticanres.16922 [doi]
PST - ppublish
SO  - Anticancer Res. 2024 Mar;44(3):1271-1279. doi: 10.21873/anticanres.16922.