Prognostic factors in patients with metastatic urothelial carcinoma who have been treated with atezolizumab

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dc.contributor.authorTural, Deniz
dc.contributor.authorÖlmez, Ömer Fatih
dc.contributor.authorSümbül, Ahmet Taner
dc.contributor.authorÖzhan, Nail
dc.contributor.authorAkar, Ebru
dc.contributor.authorÇakar, Bilge
dc.contributor.authorKöstek, Osman
dc.contributor.authorEkenel, Mahmut
dc.contributor.authorErman, Mustafa
dc.contributor.authorCoşkun, Hasan Şenol
dc.contributor.authorSelçukbiricik, Fatih
dc.contributor.authorKeskin, Özge
dc.contributor.authorPaksoy, Fatma
dc.contributor.authorOruç, Korkmaz
dc.contributor.authorBayram, Süleyman Nuri
dc.contributor.authorYılmaz, Uğur
dc.contributor.authorBilgetekin, İrem
dc.contributor.authorYıldız, Birol
dc.contributor.authorŞendur, Mehmet Ali Nahit
dc.contributor.authorArtaç, Macide
dc.date.accessioned2020-10-30T10:08:37Z
dc.date.available2020-10-30T10:08:37Z
dc.date.issued2020
dc.departmentİstanbul Medipol Üniversitesi, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, İç Hastalıkları Ana Bilim Dalı
dc.description.abstractBackground: In the current study, we evaluated pretreatment prognostic factors foroverall survival (OS) in patients with metastatic urothelial carcinoma who have progressed after first-line chemotherapy in the Expanded-Access Program ofatezolizumab.Methods: In this study, we present the retrospective analysis of 113 patients withurothelial cancer treated with ATZ after progression on first-line chemotherapy.Eligible patients included metastatic urothelial carcinoma patients treated with at leastone course of ATZ. Univariate analysis was used to identify clinical and laboratoryfactors that significantly impact OS. Variables were retained for multivariate analysis ifthey had a statistical relationship with OS (P?0.1) and were then included the finalmodel if P?0.05.Results: In univariate analysis, primary tumour location in the upper tract, increasedabsolute neutrophil count (ANC), increased absolute lymphocyte count, neutrophil-tolymphocyte ratio (NLR)>3, liver metastases, baseline creatinine clearance (GFR) < 60ml/min, Eastern Cooperative Oncology Group (ECOG) performance status (1) andhemoglobin<10 mg/dl were all significantly associated with OS. Three of the fiveadverse prognostic factors according to the Bellmunt criteria were independent ofshort survival: liver metastases (HR¼ 0.323; 95% CI 0.174-0.60; P <0.001), ECOG PS1(HR¼ 0.459; 95% CI 0.236-0.895; p¼0.022), and haemoglobin level <10 mg/dl (HR¼0.373; 95% CI 0.217-0.642; P <0.001). In addition, NLR>3 (HR¼ 0.474; 95% CI 0.234-0.962; P ¼0.039) and GFR <60 ml/min (HR¼ 0.546; 95% CI 0.328-0.907; P ¼ 0.019),maintained a significant association with OS in multivariate analysis. Patients weredivided into three risk categories: the favourable risk group (0-1 prognostic factor;median OS¼20.1 mo.), the intermediate-risk group (2 prognostic factors; medianOS¼10.08 mo.) and the poor-risk group (3 prognostic risk groups; median OS¼ 2.2mo.) (log-rank P< 0.001).Conclusions: This model confirms the Bellmunt model with the addition of NLR>3 andGFR <60 ml/min. Taken together, these factors can be used for prognostic parametersin clinical trials that use immunotherapy in patients with bladder cancer who haveprogressed after first-line chemotherapy.
dc.description.sponsorshipEuropean Society for Medical Oncologyen_US
dc.identifier.citationTural, D., Ölmez, Ö. F., Sümbül, A. T., Özhan, N., Akar, E., Çakar, B. ... Artaç, M. (2020). Prognostic factors in patients with metastatic urothelial carcinoma who have been treated with atezolizumab. ESMO Virtual Congress içinde (S598-S598. ss.). Electrical Network, September 19-October 18, 2020. https://dx.doi.org/10.1016/j.annonc.2020.08.853
dc.identifier.doi10.1016/j.annonc.2020.08.853
dc.identifier.endpageS598
dc.identifier.issn0923-7534
dc.identifier.issn1569-8041
dc.identifier.issueSupplement: 4
dc.identifier.startpageS598
dc.identifier.urihttps://dx.doi.org/10.1016/j.annonc.2020.08.853
dc.identifier.urihttps://hdl.handle.net/20.500.12511/5995
dc.identifier.volume31
dc.identifier.wosqualityQ1
dc.indekslendigikaynakWeb of Science
dc.language.isoen
dc.publisherElsevier
dc.relation.ispartofESMO Virtual Congressen_US
dc.relation.publicationcategoryKonferans Öğesi - Uluslararası - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectAtezolizumab
dc.subjectMetastatic Urothelial Carcinoma
dc.subjectPrognostic Factors
dc.titlePrognostic factors in patients with metastatic urothelial carcinoma who have been treated with atezolizumab
dc.typeConference Object

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