Abstract:
Objective To investigate the clinical efficacy and safety of immune checkpoint inhibitors (ICIs) in the treatment of urothelial carcinoma.
Methods Clinical data of 32 patients with urothelial carcinoma treated with ICIs at the Department of Urology of Liaoning Cancer Hospital & Institute from July 2016 to April 2019 were retrospectively analyzed.
Results Overall, the objective response rate (ORR) and disease control rate were 44% (11/25) and 64% (16/25), respectively. Complete response, partial response, stable disease, progressive disease, and lack of evaluations were found in 4, 7, 5, 9, and 7 patients, respectively. The ORR was 33.3% in patients who had received cisplatin-based chemotherapy and 60% for chemotherapy-naive patients. All patients received up to 23 cycles of treatment over 15 months, with a median treatment period of 3.5 months, which included six cycles. The most common adverse events related to ICI treatment (irAEs) in this group were fatigue, rash, and hypothyroidism. Among 32 patients, 5 (16%) received systemic corticosteroids because of irAEs.
Conclusions Second-line treatment is beneficial for unresectable local or metastatic urothelial carcinoma. For patients who might not tolerate or are unwilling to receive chemotherapy, the first-line application of ICI therapy is feasible. However, ICIs are generally well-tolerated by patients. Careful surveillance for irAEs is necessary, and early identification and continued administration of corticosteroids are important to avoid lethal events caused by irAEs.
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