Re-challenging chemotherapy for platinum-refractory urothelial carcinoma after pembrolizumab

What is it about?

This study aimed to assess the real-world clinical benefit of re-challenging chemotherapy after pembrolizumab in patients with metastatic urothelial carcinoma (mUC). Out of 236 patients treated with pembrolizumab, 105 patients were identified for the study. The median overall survival (OS) from progressive disease (PD) for pembrolizumab was 11 months. Of the 25 patients treated with re-challenging chemotherapy, platinum-including chemotherapy was offered in 20 patients (80%). The objective response rate (ORR) for the first-line chemotherapy in the 105 patients was 30%, with a comparable ORR in 25 patients treated with re-challenging chemotherapy of 28%. The ORR for the gemcitabine/cisplatin/paclitaxel (GCP) regimen was 50%. Propensity score matching was performed using putative clinical factors, from which 34 patients were identified as pair-matched groups. The OS for patients treated with re-challenging chemotherapy was significantly longer than continuing pembrolizumab (a median of 13.9 and 5.8 months, respectively: P = 0.048). Re-challenging chemotherapy including platinum agents after PD with pembrolizumab offers clinical benefits in patients with mUC.

Featured Image

Why is it important?

The research examines the real-world clinical benefit of re-challenging chemotherapy after pembrolizumab in patients with metastatic urothelial carcinoma (mUC). It offers important insights into the treatment options for patients with mUC whose tumor progressed after pembrolizumab treatment. The study demonstrates that re-challenging chemotherapy, including platinum agents, after disease progression with pembrolizumab offers clinical benefits in patients with mUC. Key Takeaways: 1. Re-challenging chemotherapy after disease progression with pembrolizumab offers clinical benefits in patients with mUC. 2. The objective response rate (ORR) for the first-line chemotherapy in the 105 patients was 30%, with a comparable ORR in 25 patients treated with re-challenging chemotherapy of 28%. 3. The median overall survival (OS) from disease progression for pembrolizumab was 11 months in 105 patients. 4. The ORR for the gemcitabine and cisplatin (GCP) regimen was 50%. 5. Patients treated with re-challenging chemotherapy had significantly longer OS than patients treated with continuing pembrolizumab.