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@article{Khaki:2021:10.1016/j.euo.2020.12.006,
author = {Khaki, AR and Li, A and Diamantopoulos, LN and Miller, NJ and Carril-Ajuria, L and Castellano, D and De, Kouchkovsky I and Koshkin, V and Park, J and Alva, A and Bilen, MA and Stewart, T and Santos, V and Agarwal, N and Jain, J and Zakharia, Y and Morales-Barrera, R and Devitt, M and Nelson, A and Hoimes, CJ and Shreck, E and Gartrell, BA and Sankin, A and Tripathi, A and Zakopoulou, R and Bamias, A and Rodriguez-Vida, A and Drakaki, A and Liu, S and Kumar, V and Lythgoe, MP and Pinato, DJ and Murgic, J and Fröbe, A and Joshi, M and Isaacsson, Velho P and Hahn, N and Alonso, Buznego L and Duran, I and Moses, M and Barata, P and Galsky, MD and Sonpavde, G and Yu, EY and Shankaran, V and Lyman, GH and Grivas, P},
doi = {10.1016/j.euo.2020.12.006},
journal = {European Urology Oncology},
title = {A new prognostic model in patients with advanced urothelial carcinoma treated with first-line immune checkpoint inhibitors},
url = {http://dx.doi.org/10.1016/j.euo.2020.12.006},
year = {2021}
}
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TY  - JOUR
AB  - BACKGROUND: While immune checkpoint inhibitors (ICIs) are approved in the first-line (1L) setting for cisplatin-unfit patients with programmed death-ligand 1 (PD-L1)-high tumors or for platinum (cisplatin/carboplatin)-unfit patients, response rates remain modest and outcomes vary with no clinically useful biomarkers (except for PD-L1). OBJECTIVE: We aimed to develop a prognostic model for overall survival (OS) in patients receiving 1L ICIs for advanced urothelial cancer (aUC) in a multicenter cohort study. DESIGN, SETTING, AND PARTICIPANTS: Patients treated with 1L ICIs for aUC across 24 institutions and five countries (in the USA and Europe) outside clinical trials were included in this study. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: We used a stepwise, hypothesis-driven approach using clinician-selected covariates to develop a new risk score for patients receiving ICIs in the 1L setting. Demographics, clinicopathologic data, treatment patterns, and OS were collected uniformly. Univariate Cox regression was performed on 18 covariates hypothesized to be associated with OS based on published data. Variables were retained for multivariate analysis (MVA) if they correlated with OS (p < 0.2) and were included in the final model if p < 0.05 on MVA. Retained covariates were assigned points based on the beta coefficient to create a risk score. Stratified median OS and C-statistic were calculated. RESULTS AND LIMITATIONS: Among 984 patients, 357 with a mean age of 71 yr were included in the analysis, 27% were female, 68% had pure UC, and 13% had upper tract UC. Eastern Cooperative Oncology Group performance status ≥2, albumin <3.5 g/dl, neutrophil:lymphocyte ratio >5, and liver metastases were significant prognostic factors on MVA and were included in the risk score. C index for new 1L risk score was 0.68 (95% confidence interval 0.65-0.71). Limitations include retrospective nature and lack of external validation. CONCLUSIONS: We developed a new 1L ICI
AU  - Khaki,AR
AU  - Li,A
AU  - Diamantopoulos,LN
AU  - Miller,NJ
AU  - Carril-Ajuria,L
AU  - Castellano,D
AU  - De,Kouchkovsky I
AU  - Koshkin,V
AU  - Park,J
AU  - Alva,A
AU  - Bilen,MA
AU  - Stewart,T
AU  - Santos,V
AU  - Agarwal,N
AU  - Jain,J
AU  - Zakharia,Y
AU  - Morales-Barrera,R
AU  - Devitt,M
AU  - Nelson,A
AU  - Hoimes,CJ
AU  - Shreck,E
AU  - Gartrell,BA
AU  - Sankin,A
AU  - Tripathi,A
AU  - Zakopoulou,R
AU  - Bamias,A
AU  - Rodriguez-Vida,A
AU  - Drakaki,A
AU  - Liu,S
AU  - Kumar,V
AU  - Lythgoe,MP
AU  - Pinato,DJ
AU  - Murgic,J
AU  - Fröbe,A
AU  - Joshi,M
AU  - Isaacsson,Velho P
AU  - Hahn,N
AU  - Alonso,Buznego L
AU  - Duran,I
AU  - Moses,M
AU  - Barata,P
AU  - Galsky,MD
AU  - Sonpavde,G
AU  - Yu,EY
AU  - Shankaran,V
AU  - Lyman,GH
AU  - Grivas,P
DO  - 10.1016/j.euo.2020.12.006
PY  - 2021///
SN  - 2588-9311
TI  - A new prognostic model in patients with advanced urothelial carcinoma treated with first-line immune checkpoint inhibitors
T2  - European Urology Oncology
UR  - http://dx.doi.org/10.1016/j.euo.2020.12.006
UR  - https://www.ncbi.nlm.nih.gov/pubmed/33423945
ER  -
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