You have accessJournal of UrologyBladder Cancer: Invasive II (MP41)1 Sep 2021MP41-16 PEMBROLIZUMAB VS. CONVENTIONAL CHEMOTHERAPY AFTER FIRST-LINE PLATINUM-BASED CHEMOTHERAPY FOR ADVANCED UROTHELIAL CARCINOMA IN REAL-WORLD PRACTICE: A MULTICENTER RETROSPECTIVE STUDY Takuma Narita, Shingo Hatakeyama, Kazuyuki Numakura, Mizuki Kobayashi, Yumina Muto, Mitsuru Saito, Shintaro Narita Akita, Japan, Toshikazu Tanaka, Daisuke Noro, Noriko Tokui, Takahiro Yoneyama, Yasuhiro Hashimoto, Tomonori Habuchi, and Chikara Ohyama Takuma NaritaTakuma Narita More articles by this author , Shingo HatakeyamaShingo Hatakeyama More articles by this author , Kazuyuki NumakuraKazuyuki Numakura More articles by this author , Mizuki KobayashiMizuki Kobayashi More articles by this author , Yumina MutoYumina Muto More articles by this author , Mitsuru SaitoMitsuru Saito More articles by this author , Shintaro Narita Akita, JapanShintaro Narita Akita, Japan More articles by this author , Toshikazu TanakaToshikazu Tanaka More articles by this author , Daisuke NoroDaisuke Noro More articles by this author , Noriko TokuiNoriko Tokui More articles by this author , Takahiro YoneyamaTakahiro Yoneyama More articles by this author , Yasuhiro HashimotoYasuhiro Hashimoto More articles by this author , Tomonori HabuchiTomonori Habuchi More articles by this author , and Chikara OhyamaChikara Ohyama More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002062.16AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The clinical benefit of pembrolizumab as second-line therapy for advanced urothelial carcinoma (aUC) remains unclear in real-world practice. Hence, we retrospectively compared the effects of pembrolizumab with those of conventional chemotherapy on the prognosis of patients with aUC. In addition, we examined the efficacy and safety of pembrolizumab. METHODS: At six hospitals between January 2004 and August 2020, we compared the oncological outcomes between the patients treated with pembrolizumab (Pemb group) and those treated with conventional chemotherapy (Chemo group) using Kaplan-Meier curve analysis and multivariate Cox regression analysis with the inverse probability of treatment weighting (IPTW) method. We also compared oncological outcomes between the immune-related adverse events (irAE) (+) and irAE (-) in the Pemb group. RESULTS: The numbers of patients in the Pemb and Chemo groups were 121 and 67, respectively. Patients in the Pemb group were significantly older (median: 72 vs. 66, p=0.001), and had poor Eastern Cooperative Oncology Group performance status (median: 1 vs. 0, p=0.001). The unadjusted Kaplan-Meier curve analysis showed no significant differences in the median overall survival (OS) from the first-line chemotherapy (24.7 months vs. 16.3 months, p=0.159, Fig. A). IPTW-adjusted multivariate Cox hazard proportional analyses showed a significant difference between the Pemb and Chemo groups in OS (p = 0.003, HR 0.63, Fig. B). The overall response rate for patients with irAE was significantly better than that for patients without irAEs (36.4% vs. 16.9%, p=0.044, Fig. C). Kaplan-Meier analyses showed significant differences between patients with or without irAE in OS (p=0.047, HR 0.59, 95%CI 0.35-0.99, Fig. D). CONCLUSIONS: Despite the non-negligible age difference between the trial and our clinical practice, our study supports the benefit of second-line pembrolizumab over chemotherapy in real-world practice. Source of Funding: This study was supported by the Japan Society for the Promotion of Science KAENHI (Grant Numbers 20K18130 and 20K09517) © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e767-e767 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Takuma Narita More articles by this author Shingo Hatakeyama More articles by this author Kazuyuki Numakura More articles by this author Mizuki Kobayashi More articles by this author Yumina Muto More articles by this author Mitsuru Saito More articles by this author Shintaro Narita Akita, Japan More articles by this author Toshikazu Tanaka More articles by this author Daisuke Noro More articles by this author Noriko Tokui More articles by this author Takahiro Yoneyama More articles by this author Yasuhiro Hashimoto More articles by this author Tomonori Habuchi More articles by this author Chikara Ohyama More articles by this author Expand All Advertisement Loading ...