Atezolizumab in locally advanced or metastatic urothelial cancer: a pooled analysis from the Spanish patients of the IMvigor 210 cohort 2 and 211 studies

• M. Sotelo ^[3] ; T. Alonso-Gordoa ^[4] ; P. Gajate ^[4] ; E. Gallardo ^[5] ; R. Morales-Barrera ^[6] ; J.L. Pérez-Gracia ^[1] ; J. Puente ^[2] ; P. Sánchez ^[7] ; D. Castellano ^[8] ; I. Durán ^[3]
  1. [1] Gobierno de Navarra

     Gobierno de Navarra

     Pamplona, España

     
  2. [2] Hospital Clínico San Carlos de Madrid

     Hospital Clínico San Carlos de Madrid

     Madrid, España

     
  3. [3] Marqués de Valdecilla University Hospital
  4. [4] Ramon y Cajal University Hospital, Madrid
  5. [5] Parc Taulí Hospital Universitari
  6. [6] Vall d’Hebron University Hospital, Barcelona
  7. [7] Medical Department, Roche Farma S.A., Madrid
  8. [8] Doce de Octubre University Hospital, Madrid

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• Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 23, Nº. 4, 2021, págs. 882-891
• Idioma: inglés
• Texto completo no disponible (Saber más ...)
• Resumen

  • Background The studies IMvigor 210 cohort 2 and IMvigor211 evaluated the efficacy of atezolizumab in patients with locally advanced or metastatic urothelial cancer (mUC) upon progression to platinum-based chemotherapy worldwide. Yet, the real impact of this drug in specific geographical regions is unknown.

    Materials and methods We combined individual-level data from the 131 patients recruited in Spain from IMvigor210 cohort 2 and IMvigor211 in a pooled analysis. Efficacy and safety outcomes were assessed in the overall study population and according to PD-L1 expression on tumour-infiltrating immune cells.

    Results Full data were available for 127 patients; 74 (58%) received atezolizumab and 53 (42%) chemotherapy. Atezolizumab patients had a numerically superior median overall survival although not reaching statistical significance (9.2 months vs 7.7 months). No statistically significant differences between arms were observed in overall response rates (20.3% vs 37.0%) or progression-free survival (2.1 months vs 5.3 months). Nonetheless, median duration of response was superior for the immunotherapy arm (non-reached vs 6.4 months; p = 0.005). Additionally, among the responders, the 12-month survival rates seemed to favour atezolizumab (66.7% vs 19.9%). When efficacy was analyzed based on PD-L1 expression status, no significant differences were found. Treatment-related adverse events of any grade occurred more frequently in the chemotherapy arm [46/57 (81%) vs 44/74 (59%)].

    Conclusion Patients who achieved an objective response on atezolizumab presented a longer median duration of response and numerically superior 12 month survival rates when compared with chemotherapy responders along with a more favorable safety profile. PD-L1 expression did not discriminate patients who might benefit from atezolizumab.