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Long-Term Outcomes With Atezolizumab in Metastatic Urothelial Carcinoma

By: Joseph Fanelli
Posted: Monday, March 12, 2018

According to a study published in JAMA Oncology, the long-term use of atezolizumab therapy for patients with metastatic urothelial carcinoma yields enduring clinical benefits. Although this programmed cell death ligand 1 (PD-L1) inhibitor has demonstrated safety and activity in previous studies, its long-term benefits have remained unclear.

“With an extended median follow-up of more than 3 years, this analysis demonstrates continued tolerability of atezolizumab in the metastatic urothelial carcinoma cohort of this phase I study,” concluded lead author Daniel P. Petrylak, MD, of the Yale Cancer Center, and colleagues. Ongoing studies of this agent as monotherapy and in combination therapies in an assortment of settings are needed to confirm these clinical correlates of response and survival in this patient population, they noted.

The investigators reported on a cohort of 95 evaluable patients treated with atezolizumab in this clinical trial. They observed response in 25 patients (26%), with a complete response in 9 patients. The median progression-free survival was 2.7 months, and the median overall survival was 10.1 months, with a 3-year overall survival rate of 27%. Of 40 patients with PD-L1 expression of ≥ 5% tumor-infiltrating immune cells, response occurred in 40%, compared with 11% in 44 patients with PD-L1 expression < 5%.

Grade 3 or 4 adverse events were reported in 53% of patients, with 9% related to treatment. The most common events were fatigue (18%), asthenia (14%), decreased appetite (13%), and pruritus (13%).

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