Immune-related adverse events after inhibitor use linked to benefit in urothelial cancer
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Patients with urothelial carcinoma who experienced an immune-related adverse event following checkpoint blockade had significantly improved clinical outcomes, according to a poster presented at ASCO Genitourinary Cancers Symposium.
The findings suggest immune-related adverse events could be a prognostic biomarker of positive response to immune checkpoint inhibitors, which have continued to show promise in advanced bladder cancer, according to Gregory E. Sanda, of the department of hematology and medical oncology at Emory University School of Medicine, and colleagues.
The retrospective study included 70 patients with urothelial carcinoma (median age, 69.5 years; 71.4% white; 70% men) who received immune checkpoint inhibitor therapy at Winship Cancer Institute of Emory University between 2015 and 2020. Nearly half of patients (46.4%) had an ECOG performance status of zero and most (81.4%) had at least one prior line of treatment. About one-third of patients (35.7%) had one or more immune-related adverse events, most commonly dermatologic (12.9%) and arthralgia (0.5%).
The researchers examined OS from the time of inhibitor initiation, clinical or radiographic PFS, and clinical benefit, defined as best radiographic or complete response, partial response, or stable disease for at least 6 months according to RECIST version 1.1. They modeled associations with OS and PFS using Cox proportional hazards and multivariable analysis.
Median follow-up was 20.07 months (95% CI, 12.47-30.79).
Results showed significant associations of having vs. not having an immune-related adverse event with longer OS (median, not reached vs. 7.1 months; HR = 0.38; 95% CI, 0.18-0.79), longer PFS (median, 8.5 months vs. 2.2 months; HR = 0.27; 95% CI, 0.14-0.53) and a higher clinical benefit rate (52% vs. 23%; OR = 4.2; 95% CI, 1.35-13.06). Researchers also reported associations specifically among patients with dermatologic immune-related adverse events (n = 9) vs. those without them (median OS, not reached vs. 9.2 months; HR = 0.23; 95% CI, 0.07-0.78; median PFS, 33.3 months vs. 2.6 months; HR = 0.18; 95% CI, 0.06-0.53; clinical benefit rate, 67% vs. 29%; HR = 7.68; 95% CI, 1.51-38.93).
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Sanda GE, et al. Poster 71. Presented at: ASCO Genitourinary Cancers Symposium; Feb. 17-19, 2022; San Francisco.
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