Predictors of Efficacy of Immune Checkpoint Inhibitors in Patients With Advanced Urothelial Carcinoma: A Systematic Review and Meta-Analysis

Matteo Ferro; Felice Crocetto; Sabin Tataru; Biagio Barone; Pasquale Dolce; Giuseppe Lucarelli; Guru Sonpavde; Gennaro Musi; Alessandro Antonelli; Alessandro Veccia; Daniela Terracciano; Gian Maria Busetto; Francesco Del Giudice; Michele Marchioni; Luigi Schips; Francesco Porpiglia; Cristian Fiori; Giuseppe Carrieri; Francesco Lasorsa; Antonio Verde; Luca Scafuri; Carlo Buonerba; Giuseppe Di Lorenzo

doi:10.1016/j.clgc.2023.05.017

Predictors of Efficacy of Immune Checkpoint Inhibitors in Patients With Advanced Urothelial Carcinoma: A Systematic Review and Meta-Analysis

Clin Genitourin Cancer. 2023 Oct;21(5):574-583. doi: 10.1016/j.clgc.2023.05.017. Epub 2023 May 27.

Authors

Matteo Ferro¹, Felice Crocetto², Sabin Tataru³, Biagio Barone², Pasquale Dolce⁴, Giuseppe Lucarelli⁵, Guru Sonpavde⁶, Gennaro Musi³, Alessandro Antonelli⁷, Alessandro Veccia⁷, Daniela Terracciano⁸, Gian Maria Busetto⁹, Francesco Del Giudice¹⁰, Michele Marchioni¹¹, Luigi Schips¹¹, Francesco Porpiglia¹², Cristian Fiori¹², Giuseppe Carrieri⁹, Francesco Lasorsa⁵, Antonio Verde¹¹, Luca Scafuri¹³, Carlo Buonerba¹³, Giuseppe Di Lorenzo¹³

Affiliations

¹ Department of Urology, IEO, European Institute of Oncology IRCCS, Milan, Italy. Electronic address: matteo.ferro@ieo.it.
² Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy.
³ Department of Urology, IEO, European Institute of Oncology IRCCS, Milan, Italy.
⁴ Department of Public Health, Federico II University of Naples, Naples, Italy.
⁵ Urology, Andrology and Kidney Transplantation Unit, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy.
⁶ Genitourinary Oncology and Phase I Section, AdventHealth Cancer Institute, Orlando, FL.
⁷ Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
⁸ Department of Translational Medical Sciences, University of Naples "Federico II", Naples, Italy.
⁹ Department of Urology and Organ Transplantation, University of Foggia, Foggia, Italy.
¹⁰ Department of Maternal Infant and Urologic Sciences, Policlinico Umberto I Hospital, "Sapienza" University of Rome, Rome, Italy.
¹¹ Department of Urology, University of Chieti, Chieti, Italy.
¹² School of Medicine, Division of Urology, Department of Oncology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Turin, Italy.
¹³ Oncology Unit, Hospital "Andrea Tortora," ASL Salerno, Pagani, Italy; Associazione O.R.A., Somma Vesuviana, Italy.

PMID: 37419854
DOI: 10.1016/j.clgc.2023.05.017

Abstract

Introduction: Several programmed death ligand-1 (PD1/L1) immune checkpoint inhibitors (ICIs) are approved in urothelial carcinoma (UC).

Patients and methods: To address the need for predictors of the efficacy of ICIs in metastatic urothelial carcinoma (mUC), randomized controlled trials of PD1/L1 inhibitors alone or in combination with chemotherapy in this patient population were systematically reviewed, and differences in ICI-associated survival outcomes according to available baseline variables were quantitatively assessed.

Results: The quantitative analysis included 6524 patients with mUC. No visceral metastatic site (HR 0.67; 95% CI, 0.76-0.90) and high PDL-1 expression (HR 0.74; 95% CI, 0.640.87) were significantly associated with a reduced risk of death.

Conclusion: Treatment with an ICI-containing regimen was associated with a reduced risk of death in mUC patients, which was associated with PDL-1 expression and metastatic site. Further research is warranted.

Keywords: Bladder cancer; Chemotherapy; Immunotherapy; Metastasis; Visceral metastasis.

Publication types

Meta-Analysis
Systematic Review

MeSH terms

Carcinoma, Transitional Cell* / drug therapy
Humans
Immune Checkpoint Inhibitors / therapeutic use
Urinary Bladder Neoplasms* / drug therapy

Substances

Immune Checkpoint Inhibitors