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Comparison of pembrolizumab with conventional chemotherapy after first‐line platinum‐based chemotherapy for advanced urothelial carcinoma in real‐world practice: A multicenter retrospective study
Author(s) -
Narita Takuma,
Hatakeyama Shingo,
Numakura Kazuyuki,
Kobayashi Mizuki,
Muto Yumina,
Saito Mitsuru,
Narita Shintaro,
Tanaka Toshikazu,
Noro Daisuke,
Tokui Noriko,
Yoneyama Takahiro,
Hashimoto Yasuhiro,
Habuchi Tomonori,
Ohyama Chikara
Publication year - 2021
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/iju.14601
Subject(s) - pembrolizumab , medicine , proportional hazards model , chemotherapy , hazard ratio , oncology , survival analysis , multivariate analysis , cancer , confidence interval , immunotherapy
Objectives To assess the clinical benefit of pembrolizumab as second‐line therapy for advanced urothelial carcinoma. Methods We retrospectively compared the effects of pembrolizumab with those of conventional chemotherapy on the prognosis of patients with advanced urothelial carcinoma at six hospitals between January 2004 and August 2020. We compared the oncological outcomes between the patients treated with pembrolizumab and those treated with conventional chemotherapy using Kaplan–Meier curve analysis and multivariate Cox regression analysis with the inverse probability of treatment weighting method. Results The numbers of patients in the pembrolizumab and chemotherapy groups were 121 and 67, respectively. Patients in the pembrolizumab group were significantly older (median 72 vs 66 years, P = 0.001), and had poor Eastern Cooperative Oncology Group performance status (median 1 vs 0, P = 0.001). The unadjusted Kaplan–Meier curve analysis showed no significant differences in the median overall survival from the first‐line chemotherapy (24.7 months vs 16.3 months, P = 0.159). Inverse probability of treatment weighting‐adjusted multivariate Cox proportional hazards analyses showed a significant difference between the pembrolizumab and chemotherapy groups in overall survival ( P = 0.003, hazard ratio 0.63). Conclusions Despite the non‐negligible age difference between the trial and our clinical practice, our study supports the benefit of second‐line pembrolizumab over chemotherapy in real‐world practice.