Metastatic Urothelial Cancer: Does Prior Treatment Hinder the Effectiveness of Pembrolizumab Therapy?
Posted: Wednesday, December 1, 2021
Prior treatment of non–muscle-invasive bladder cancer treatment may not alter subsequent clinical outcomes with the anti–PD-1 inhibitor pembrolizumab for metastatic chemotherapy-resistant urothelial carcinoma, according to Mikio Sugimoto, MD, PhD, of Kagawa University, Japan, and colleagues. In fact, a history of prior treatment of non–muscle-invasive bladder cancer, including intravesical bacillus Calmette-Guérin (BCG) therapy, did not appear to impact overall survival, objective response rate, or disease control rate following pembrolizumab treatment compared with patients without such a history.
“These results indicate that non–muscle-invasive bladder cancer treatment history, including intravesical BCG therapy, is not an independent prognostic factor in this clinical setting,” stated the study investigators. The findings of this retrospective study were published in the journal Urologic Oncology: Seminars and Original Investigations.
Clinicopathologic data were retrospectively reviewed from patients with metastatic, chemotherapy-resistant urothelial carcinoma who had received pembrolizumab therapy (n = 755). Via a risk-adjusted analysis, patients with a history of non–muscle-invasive bladder cancer treatment (n = 155), including the 12.8% who received BCG therapy, were compared with patients without such a history (n = 600).
Overall survival from the initiation of pembrolizumab therapy was found to be similar at a median follow-up of 10.0 months for patients without versus with a history of non–muscle-invasive bladder cancer (13.3 months). Further, overall survival for patients with a history of non–muscle-invasive bladder cancer who received BCG therapy (12.1 months) or did not receive BCG therapy (14.5 months) was not found to be significantly different from patients without such a history. The objective response rate (24.5% vs. 31.0%) and disease-control rate (56.1% vs. 52.1%) were found to be similar for patients with or without a history of non–muscle-invasive bladder cancer. Similarly, there appeared to be no difference in overall survival or disease control rate for those who had a history of non–muscle-invasive bladder cancer with or without BCG therapy.
Disclosure: The study authors reported no conflicts of interest.