1. Site-Specific Differences in PD-1 Blockade Success and Biomarkers in Urothelial Carcinoma Treated with Pembrolizumab.
- Author
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Kota Umeda, Nobuyuki Tanaka, Yota Yasumizu, Toshikazu Takeda, Kazuhiro Matsumoto, Shinya Morita, Takeo Kosaka, Ryuichi Mizuno, and Mototsugu Oya
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TRANSITIONAL cell carcinoma , *PEMBROLIZUMAB , *URINARY organ cancer treatment , *TUMOR microenvironment , *DRUG administration - Abstract
Targeting PD-1/PD-L1 has shown the ability to improve overall survival in urothelial carcinoma; however, there are cases of nonresponse and resistance. In this study, we evaluated time-course changes in all tumor locations after pembrolizumab treatment to examine the differences in immune checkpoint inhibitor efficacy in different organs. We also examined the usefulness of neutrophil-to-lymphocyte ratio, CRP, and kinetics as prognostic biomarkers in urothelial carcinoma treated with pembrolizumab. Introduction: Since tumors in different human organs may have different tumor microenvironments, we evaluate timecourse changes in all tumor locations after pembrolizumab treatment in urothelial carcinoma (UC) to examine the differences in efficacy of pembrolizumab per organ. Further, we uncover the usefulness of inflammatory markers such as neutrophil-to-lymphocyte ratio (NLR), CRP, and kinetics of these markers to predict pembrolizumab success and relation to overall survival (OS) in UC. Patients and Methods: A total of 115 cancerous lesions from 44 UC patients were measurable based on RECIST 1.1 cr iter ia. The ser um CRP and NLR levels were measured at baseline prior to pembrolizumab treatment and at least every 3 weeks just prior to pembrolizumab administration. Results: Site-specific success (ie, patients with CR/PR/SD by RESIST 1.1) rates for pembrolizumab treatments were as follows: primary tumors: 67%, lymph node: 70%, lung: 44%, liver: 40%, and peritoneal metastasis: 56%. Focusing on the major metastasis sites, lymph nodes and lungs, we examined the relationships between NLR, CRP, or that kinetics and pembrolizumab success. In lymph nodes, both early NLR kinetics (P = .005) and CRP kinetics (P = .035) was a predictor for pembrolizumab success. On the other hand, none of 4 was not in lung metastases. Regarding to the mortality, the multivariate analysis revealed that early NLR kinetics was a prognostic biomarker for OS among the 4, independent of performance status and liver metastasis. Conclusion: We revealed that site-specific pembrolizumab success in UC. Early NLR kinetics was a predictor for lymph node pembrolizumab success and OS in our cohorts. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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