Programmed cell death 1 inhibitor alone or combined with chemotherapy for patients with locally advanced or metastatic urothelial carcinoma: a single-center experience
Abstract Background Immune checkpoint inhibitors (ICIs) alone or in combination with standard chemotherapy for advanced urothelial carcinoma (UC) have been tested as first-line treatment in clinical trials. This study aimed to evaluate the clinical outcomes of programmed cell death 1 (PD-1) inhibito...
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2024-12-01
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| Online Access: | https://doi.org/10.1186/s12894-024-01674-7 |
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| author | Xing Huang Chupeng Sun Peng Zhang Lei Wang |
| author_facet | Xing Huang Chupeng Sun Peng Zhang Lei Wang |
| author_sort | Xing Huang |
| collection | DOAJ |
| description | Abstract Background Immune checkpoint inhibitors (ICIs) alone or in combination with standard chemotherapy for advanced urothelial carcinoma (UC) have been tested as first-line treatment in clinical trials. This study aimed to evaluate the clinical outcomes of programmed cell death 1 (PD-1) inhibitor alone or combined with chemotherapy for patients with locally advanced or metastatic UC in a real world clinical care setting, and sought to identify prognostic factors for overall survival (OS). Methods A retrospective, real-world study involving 35 locally advanced or metastatic UC patients treated with PD-1 inhibitor alone or in combination with chemotherapy was conducted. Kaplan–Meier curves were used to assess progression-free survival (PFS) and OS. A Cox regression analysis was conducted to explore the association of baseline variables with OS. Results In our cohort of 35 patients, 7 patients were treated with PD-1 inhibitor alone and 28 with PD-1 inhibitor plus platinum-based chemotherapy. The median OS was 16.0 months (95% CI: 11.9–20.1), and median PFS was 12.0 months (95% CI: 8.6–15.4) for all patients. PD-1 inhibitor combined with chemotherapy was associated with better PFS than PD-1 inhibitor monotherapy (HR: 0.19, p = 0.018). Treatment-related adverse events (AEs) of any grade occurred in 5 (71.4%) patients who received PD-1 inhibitor and 24 (85.7%) patients who received PD-1 inhibitor plus chemotherapy. Eastern Cooperative Oncology Group (ECOG) performance status (PS) and neutrophil-lymphocyte ratio (NLR) were identified as prognostic factors. Conclusion This study suggested that patients with locally advanced or metastatic UC could benefit from PD-1 inhibitor alone or combined with chemotherapy in daily clinical practice. ECOG PS and NLR can be used for prognostication of survival. |
| format | Article |
| id | doaj-art-ba2cbf3167b0474e94a34587aa61e6d4 |
| institution | Kabale University |
| issn | 1471-2490 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | BMC |
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| series | BMC Urology |
| spelling | doaj-art-ba2cbf3167b0474e94a34587aa61e6d42025-01-05T12:47:47ZengBMCBMC Urology1471-24902024-12-012411910.1186/s12894-024-01674-7Programmed cell death 1 inhibitor alone or combined with chemotherapy for patients with locally advanced or metastatic urothelial carcinoma: a single-center experienceXing Huang0Chupeng Sun1Peng Zhang2Lei Wang3Department of Urology, The First Affiliated Hospital, Zhejiang University School of MedicineDepartment of Radiation and Medical Oncology, Zhongnan Hospital of Wuhan UniversityDepartment of Urology, Zhongnan Hospital of Wuhan UniversityDepartment of Radiation Oncology, The First Affiliated Hospital, Zhejiang University School of MedicineAbstract Background Immune checkpoint inhibitors (ICIs) alone or in combination with standard chemotherapy for advanced urothelial carcinoma (UC) have been tested as first-line treatment in clinical trials. This study aimed to evaluate the clinical outcomes of programmed cell death 1 (PD-1) inhibitor alone or combined with chemotherapy for patients with locally advanced or metastatic UC in a real world clinical care setting, and sought to identify prognostic factors for overall survival (OS). Methods A retrospective, real-world study involving 35 locally advanced or metastatic UC patients treated with PD-1 inhibitor alone or in combination with chemotherapy was conducted. Kaplan–Meier curves were used to assess progression-free survival (PFS) and OS. A Cox regression analysis was conducted to explore the association of baseline variables with OS. Results In our cohort of 35 patients, 7 patients were treated with PD-1 inhibitor alone and 28 with PD-1 inhibitor plus platinum-based chemotherapy. The median OS was 16.0 months (95% CI: 11.9–20.1), and median PFS was 12.0 months (95% CI: 8.6–15.4) for all patients. PD-1 inhibitor combined with chemotherapy was associated with better PFS than PD-1 inhibitor monotherapy (HR: 0.19, p = 0.018). Treatment-related adverse events (AEs) of any grade occurred in 5 (71.4%) patients who received PD-1 inhibitor and 24 (85.7%) patients who received PD-1 inhibitor plus chemotherapy. Eastern Cooperative Oncology Group (ECOG) performance status (PS) and neutrophil-lymphocyte ratio (NLR) were identified as prognostic factors. Conclusion This study suggested that patients with locally advanced or metastatic UC could benefit from PD-1 inhibitor alone or combined with chemotherapy in daily clinical practice. ECOG PS and NLR can be used for prognostication of survival.https://doi.org/10.1186/s12894-024-01674-7Programmed cell death 1ChemotherapyEfficacyPrognosisUrothelial carcinoma |
| spellingShingle | Xing Huang Chupeng Sun Peng Zhang Lei Wang Programmed cell death 1 inhibitor alone or combined with chemotherapy for patients with locally advanced or metastatic urothelial carcinoma: a single-center experience BMC Urology Programmed cell death 1 Chemotherapy Efficacy Prognosis Urothelial carcinoma |
| title | Programmed cell death 1 inhibitor alone or combined with chemotherapy for patients with locally advanced or metastatic urothelial carcinoma: a single-center experience |
| title_full | Programmed cell death 1 inhibitor alone or combined with chemotherapy for patients with locally advanced or metastatic urothelial carcinoma: a single-center experience |
| title_fullStr | Programmed cell death 1 inhibitor alone or combined with chemotherapy for patients with locally advanced or metastatic urothelial carcinoma: a single-center experience |
| title_full_unstemmed | Programmed cell death 1 inhibitor alone or combined with chemotherapy for patients with locally advanced or metastatic urothelial carcinoma: a single-center experience |
| title_short | Programmed cell death 1 inhibitor alone or combined with chemotherapy for patients with locally advanced or metastatic urothelial carcinoma: a single-center experience |
| title_sort | programmed cell death 1 inhibitor alone or combined with chemotherapy for patients with locally advanced or metastatic urothelial carcinoma a single center experience |
| topic | Programmed cell death 1 Chemotherapy Efficacy Prognosis Urothelial carcinoma |
| url | https://doi.org/10.1186/s12894-024-01674-7 |
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