PD55-11 THE EFFECTS OF PLATINUM-BASED CHEMOTHERAPY RECHALLENGE FOR ADVANCED UROTHELIAL CARCINOMA PATIENTS WHOSE DISEASE PROGRESSED AFTER FIRST-LINE PLATINUM-BASED CHEMOTHERAPY AND PEMBROLIZUMAB

Abstract

You have accessJournal of UrologyBladder Cancer: Invasive IV (PD55)1 Sep 2021PD55-11 THE EFFECTS OF PLATINUM-BASED CHEMOTHERAPY RECHALLENGE FOR ADVANCED UROTHELIAL CARCINOMA PATIENTS WHOSE DISEASE PROGRESSED AFTER FIRST-LINE PLATINUM-BASED CHEMOTHERAPY AND PEMBROLIZUMAB Tetsuya Yumioka, Masashi Honda, Ryutaro Shimizu, Shogo Teraoka, Yusuke Kimura, Hideto Iwamoto, Shuichi Morizane, Katsuya Hikita, and Atsushi takenaka Tetsuya YumiokaTetsuya Yumioka More articles by this author , Masashi HondaMasashi Honda More articles by this author , Ryutaro ShimizuRyutaro Shimizu More articles by this author , Shogo TeraokaShogo Teraoka More articles by this author , Yusuke KimuraYusuke Kimura More articles by this author , Hideto IwamotoHideto Iwamoto More articles by this author , Shuichi MorizaneShuichi Morizane More articles by this author , Katsuya HikitaKatsuya Hikita More articles by this author , and Atsushi takenaka Atsushi takenaka More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002089.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Platinum-based chemotherapy is the first-line chemotherapy for advanced urothelial carcinoma (UC), while pembrolizumab is second-line. However, there was no evidence of third-line regimen for UC patients who progressed after pembrolizumab treatment. In this study, we investigated the response to platinum-based chemotherapy rechallenge for pembrolizumab refractory UC patients. METHODS: We retrospectively reviewed 14 advanced UC patients (male: 12, female 2) whose disease progressed after first-line platinum-based chemotherapy and second-line pembrolizumab therapy in our institution between January 2018 and December 2020. The regimens were paclitaxel and carboplatin (TC) or gemcitabine, docetaxel, and carboplatin (GDC). The regimen was selected based on what has not been administered to the patient previously. The overall survival was evaluated from the date the chemotherapy rechallenge began until the date of death of a patient. The tumor response was evaluated as the best response according to the Response Evaluation Criteria in Solid Tumors. Each metastatic lesion was evaluated for response. Adverse events were assessed according to the common terminology criteria for adverse events. RESULTS: The patients’ median age was 69 years (range: 45–84 years). The primary tumors were of the bladder and the upper urinary tract in 7 patients each. Metastasis was found in the lymph node in 8 patients, bone in 5, lung in 4, peritoneum in 4, liver in 3, and adrenal gland in 1. Ten of 14 patients received TC, and 4 patients received GDC. The median overall survival was 13.5 months. Complete response (CR) was achieved in 0 patients (0 %), partial response (PR) in 4 (28.6 %), stable disease (SD) in 8 (57.1 %), and progressive disease in 2 (14.3 %). The objective response rate (CR+PR) was 25.6 %. PR was observed in 3 cases (37.5 %) in the lymph node, 1 (25 %) in the lung, 3 (75 %) in the peritoneum, and 3 (100 %) in liver. Neutropenia grade 3 or more were noted in 13 patients (92.9 %), febrile neutropenia in 1 (7.1 %), anemia grade 3 or more in 5 (35.7 %), and thrombocytopenia grade 3 or more in 4 (28.6 %). CONCLUSIONS: The activity of platinum-based chemotherapy rechallenge after pembrolizumab was maintained. Platinum-based chemotherapy rechallenge may suppress tumor progression. However, since neutropenia for most of patients were observed, we must pay attention to this adverse effect. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e1001-e1002 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Tetsuya Yumioka More articles by this author Masashi Honda More articles by this author Ryutaro Shimizu More articles by this author Shogo Teraoka More articles by this author Yusuke Kimura More articles by this author Hideto Iwamoto More articles by this author Shuichi Morizane More articles by this author Katsuya Hikita More articles by this author Atsushi takenaka More articles by this author Expand All Advertisement Loading ...