Efficacy of pembrolizumab and comprehensive CD274/PD-L1 profiles in patients previously treated with chemoradiation therapy as radical treatment in bladder cancer

• DOI: 10.1136/jitc-2021-003868
• Publication Date: 2022-01-17T15:42:29Z
• Authors: Kazuki Nishimura; Kyosuke Nishio; Kensuke Hirosuna; Kazumasa Komura; Takuo Hayashi; Wataru Fukuokaya; Ayako Ura; Taizo Uchimoto; Ko Nakamura; Tatsuo Fukushima; Yusuke Yano; Nobushige Takahashi; Keita Nakamori; Shoko Kinoshita; Tomohisa Matsunaga; Takeshi Tsutsumi; Takuya Tsujino; Kohei Taniguchi; Tomohito Tanaka; Hirofumi Uehara; Kiyoshi Takahara; Teruo Inamoto; Yoshinobu Hirose; Takahiro Kimura; Shin Egawa; Haruhito Azuma
• Keywords: Male; 0301 basic medicine; Neoplasms. Tumors. Oncology. Including cancer and carcinogens; Basic Tumor Immunology; Chemoradiotherapy; Middle Aged; Antibodies, Monoclonal, Humanized; Survival Analysis; B7-H1 Antigen; 3. Good health; 03 medical and health sciences; Antineoplastic Agents, Immunological; Urinary Bladder Neoplasms; Humans; Female; RC254-282; Aged; Retrospective Studies

Chemoradiation therapy (CRT) has been increasingly reported as a possible alternative to total cystectomy (TC) for localized bladder cancer (BC). Pembrolizumab is the standard of care platinum-refractory metastatic urothelial carcinoma, although it unknown whether efficacy pembrolizumab in patients previously treated with curative CRT varies from results benchmark trials.We retrospectively assessed survival benefit differs between TC or radical treatment. A 212 patient records were collected logistic regression propensity score model. An independent dataset next-generation sequencing (n=289) and PD-L1 Combined Positive Score (CPS: n=266) was analyzed assess CRT-recurrent tumor harbors distinct CD274/PD-L1 profiles.Propensity matching performed using putative clinical factors, which 30 each arm identified pair-matched groups. There no significant difference overall initiation (p=0.80) objective response rate (p=0.59) treatment In 289 BC cohort, 22 samples (7.6%) tumors. CD274 mRNA expression level CRT-naïve The compositions isoforms comparable among all detected RNAseq (n=267) (n=22) No actionable exonic mutation CPS positively correlated level, tumors.The similar those TC. enhanced by combining programmed cell death protein 1/PD-L1 inhibitor might be expected only concurrent administration.