A study from the phase III IMvigor211 trial, has revealed that the anti-PD-L1 immune checkpoint inhibitor atezolizumab discusses survival gain in patients with locally advanced or metastatic urothelial carcinoma or mUC treated with platinum-containing chemotherapy.
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Current analysis covered the IMvigor211
intent-to-treat or ITT population. The study comprised of mUC patients who progressed
during or following platinum-based chemotherapy and were randomly assigned to
receive either atezolizumab 1,200 mg or chemotherapy (vinflunine 320 mg/m2,
paclitaxel 175mg/m2, or docetaxel 75mg/m2; choice of regimen at researcher’s
discretion) intravenously every 3 weeks.
Atezolizumab generated long-term durable remission
over a median follow-up of 33 months as compared with chemotherapy. Despite the
primary analysis showcasing no statistically significant effect on overall
survival.
The overall survival or OS rates at 24 months were
more favorable with atezolizumab than with chemotherapy which only has 13% OS vs
23% OS for atezolizumab.
Outcomes for safety were in line with the primary analysis,
and no new signals emerged. Higher grade treatment-related adverse events or
AEs occurred more frequently among chemotherapy-treated patients, as were AEs
that led to treatment discontinuation.
Meanwhile, AEs of special interest, which tended to be
grade 1-2, were more prevalent among patients who received atezolizumab, 35% vs
20%.
Regardless of PD-L1 status, the results support the
use of atezolizumab in mUC patients treated with platinum-based chemotherapy.
Source: Eur Urol 2021;doi:10.1016/j.eururo.2021.03.024