Atezolizumab in locally advanced or metastatic urothelial cancer: a pooled analysis from the Spanish patients of the IMv
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RESEARCH ARTICLE
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. Sotelo1 · T. Alonso‑Gordoa2 · P. Gajate2 · E. Gallardo3 · R. Morales‑Barrera4 · J. L. Pérez‑Gracia5 · J. Puente6 · P. Sánchez7 · D. Castellano8 · I. Durán1,9 Received: 5 June 2020 / Accepted: 18 August 2020 © The Author(s) 2020
Abstract 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. Keywords Atezolizumab · Metastatic urothelial cancer · Duration of response · Spain
* I. Durán [email protected] 1
Marqués de Valdecilla University Hospital, Edificio Sur. Despacho 277, Avda Valdecilla s/n, 39005 Santander, Spain
Ramon y Cajal University Hospital, Madrid, Spain
2 3
4
Parc Taulí Hospital Universitari, Institut d’Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain
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University Clinic of Navarra, Pamplona, Spain
6
Medical Oncology Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), CIBERONC, Madrid, Spain
7
Medical Department, Roche Farma S.A., Madrid, Spain
8
Doce de Octubre University Hospital, Madrid, Spain
9
Instituto de Invest
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