Early Serum and Hematological Responses to Pembrolizumab Therapy as Predictors of Survival in Metastatic Urothelial Cancer

Fujiwara, Motohiro; Fujiwara, Ryo; Urasaki, Tetsuya; Oguchi, Tamio; Komai, Yoshinobu; Numao, Noboru; Yamamoto, Shinya; Yonese, Junji; Yuasa, Takeshi

doi:10.21873/anticanres.15685

Cited by 5 publications

(9 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Recently, several reports have focused on the early hematological response after the induction of pembrolizumab therapy (19)(20)(21)(22). These studies demonstrated that changes between pre-and posttreatment NLR, or the absolute value of NLR after treatment, were significantly associated with patient outcomes.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Prognostic nutritional index of early post‑pembrolizumab therapy predicts long‑term survival in patients with advanced urothelial carcinoma

et al. 2022

View full text Add to dashboard Cite

Pembrolizumab has been widely used to treat advanced urothelial carcinoma that has progressed after first-line platinum-based chemotherapy. Because its clinical benefits are limited, biomarkers that can predict a good response to pembrolizumab are required. The prognostic nutritional index (PNI), calculated using the serum albumin level and peripheral lymphocyte count, has been evaluated as a predictive biomarker in cancer immunotherapy. The present study investigated the application of PNI as a predictive biomarker for pembrolizumab response in patients with advanced urothelial cancer. A retrospective study was conducted on 34 patients treated with pembrolizumab at Shiga University of Medical Science Hospital between January 2018 and July 2022. The posttreatment PNI (post-PNI) was calculated within 2 months of starting pembrolizumab. The present study investigated the association between post-PNI and objective response, overall survival (OS) and progression-free survival (PFS). The patient cohort was stratified into two categories, high and low post-PNI groups, with a cutoff value of post-PNI at 40. The higher post-PNI group demonstrated a better disease control rate than the lower post-PNI group (complete response + partial response + stable disease, 75 vs. 21%, P= 0.004). Regarding median OS, the higher post-PNI group exhibited a significantly longer survival time than the lower post-PNI group (23.1 vs. 2.9 months, P<0.001). Similarly, the higher post-PNI group exhibited a significantly longer PFS than the lower post-PNI group (10.2 vs.1.9 months, P<0.001). Multivariate analysis showed that a higher post-PNI value was an independent predictor for OS (hazard ratio, 0.04; 95% confidence interval, 0.01-0.14; P<0.001) and PFS (hazard ratio, 0.12; 95% confidence interval, 0.04-0.35; P<0.001). The present study indicated that the post-PNI was a predictor of favorable clinical outcomes in patients treated with pembrolizumab for advanced urothelial carcinoma.

show abstract

Section: Discussionmentioning

confidence: 99%

“…However, its survival benefit was relatively short (10.3 vs. 7.4 months). The objective response rate [complete response (CR)+ partial response (PR), 21.1%] was also unsatisfactory although it was significantly higher than that of the chemotherapy group (11.4%). Unfortunately, only a minority of patients benefits from pembrolizumab.…”

Section: Introductionmentioning

confidence: 96%

Prognostic nutritional index of early post‑pembrolizumab therapy predicts long‑term survival in patients with advanced urothelial carcinoma

et al. 2022

View full text Add to dashboard Cite

show abstract

“…In terms of the treatment for mUC, pembrolizumab is the currently widespread standard second‐line agent after platinum‐based chemotherapy. 3 , 4 , 5 Without investigation into the MSI status, patients with mUC undergo pembrolizumab therapy in clinical practice. One systemic review reported that, among 1087 patients with upper urinary tract UC, 51 (4.7%) assumed or verified Lynch syndrome patients were identified.…”

Section: Discussionmentioning

confidence: 99%

“…In terms of the treatment for mUC, pembrolizumab is the currently widespread standard second‐line agent after platinum‐based chemotherapy 3–5 . Without investigation into the MSI status, patients with mUC undergo pembrolizumab therapy in clinical practice.…”

Section: Discussionmentioning

confidence: 99%

“…1,2 For mUC, pembrolizumab is currently the standard second-line treatment after platinumbased chemotherapy. [3][4][5] Based on its promising anti-tumor efficacy and manageable safety profile, the paradigm of medical treatment for patients with mUC is dramatically changing. 6 UC is the third most common cancer in Lynch syndrome, following colorectal and endometrial cancers.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A radiological complete response to pembrolizumab in a patient with metastatic upper urinary tract urothelial cancer and Lynch syndrome

et al. 2022

Self Cite

View full text Add to dashboard Cite

Introduction In Lynch syndrome, urothelial cancer is the third most common cancer, following colorectal and endometrial cancers. Little is known, however, about the efficacy of immune checkpoint inhibitors in the treatment of metastatic urothelial cancer in Lynch syndrome. Case presentation A 49‐year‐old patient with metastatic urothelial cancer underwent pembrolizumab therapy after platinum‐containing chemotherapy. The efficacy of the pembrolizumab therapy was good. Her lung and bone metastatic lesions disappeared in imaging studies and her back pain decreased dramatically. Pathogenic mutations of MSH2 and BRCA2 were found in the DNA extracted from her tumor, and subsequent genetic analysis confirmed the germline pathogenic variant of MSH2. As such, this case was genetically diagnosed as Lynch syndrome. Conclusion We report metastatic urothelial cancer in a patient with Lynch syndrome who demonstrated a radiological complete response to pembrolizumab therapy. Accurate genetic diagnosis can provide useful information to both the patient and their relatives.

show abstract

A case of neoadjuvant chemotherapy‐resistant muscle‐invasive bladder cancer that markedly responded to pembrolizumab before conversion radical cystectomy

Yonese,

Numao,

Inamura

et al. 2023

IJU Case Reports

Self Cite

View full text Add to dashboard Cite

IntroductionRecently, perioperative use of immune checkpoint inhibitors has improved the prognosis of muscle‐invasive bladder cancer. It is unclear whether radical cystectomy or systemic pembrolizumab is the optimal next treatment in patients with muscle‐invasive bladder cancer and progressive disease in the pelvic lymph node following neoadjuvant chemotherapy (NAC).Case presentationA 62‐year‐old woman with cT3N0M0 bladder cancer and high programmed death‐ligand 1 expression developed solitary obturator lymph node metastasis following 5 cycles of neoadjuvant chemotherapy. Six subsequent cycles of pembrolizumab shrank the lymph node significantly, and conversion radical cystectomy was planned. Pathologically, only carcinoma in situ around the scar of transurethral resection of bladder tumor remained in the primary tumor, and the accumulation of foamy macrophages and fibrosis without viable tumor cells was observed in the dissected lymph node. Eighteen months passed without a recurrence following radical cystectomy.ConclusionPembrolizumab administration before radical cystectomy achieved a good response in a patient with obturator lymph node metastasis following neoadjuvant chemotherapy.

show abstract

Early Serum and Hematological Responses to Pembrolizumab Therapy as Predictors of Survival in Metastatic Urothelial Cancer

Cited by 5 publications

References 0 publications

Prognostic nutritional index of early post‑pembrolizumab therapy predicts long‑term survival in patients with advanced urothelial carcinoma

Prognostic nutritional index of early post‑pembrolizumab therapy predicts long‑term survival in patients with advanced urothelial carcinoma

A radiological complete response to pembrolizumab in a patient with metastatic upper urinary tract urothelial cancer and Lynch syndrome

A case of neoadjuvant chemotherapy‐resistant muscle‐invasive bladder cancer that markedly responded to pembrolizumab before conversion radical cystectomy

Contact Info

Product

Resources

About