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Abstract: Background. Atezolizumab, a programmed-death ligand-1 (PD-L1) inhibitor, is a novel treatment option for patients with metastatic urothelial cancer (mUC). Clinical prognostic factors, survival outcomes, and the safety of patients with mUC treated with atezolizumab, in a real-world setting, were investigated.Patients and methods. 62 patients with mUC, treated at the Institute of Oncology Ljubljana between May 8th 2018 and Dec 31st 2019, were included. Response rates and immune-related adverse events (irAE) were collected. Progression-free survival and overall survival times were assessed using the Kaplan-Meier method. The Cox propor-tional hazards model was applied to identify the factors affecting survival. Results. Of 62 patients, five (8.1%) have not yet been evaluated and 20 (32%) died prior to the first radiographic evaluation. We observed clinical benefit in 19 (33%), objective response in 12 (21%), and complete response in five (9%) patients. Median overall survival for the whole population was 6.8 (95% CI, 2.6–11.0), for platinum-naïve 8.7 (95% CI: 0.8–16.5), and for the platinum-treated group 6.8 (95% CI, 3.7–10) months. At the 5.8 (0.3–23.1) month median follow-up, the median duration of the response was not reached. IrAE occurred in 20 (32%) patients and seven (11%) of them discontinued the treatment. Multivariate analysis in platinum-treated patients showed that a treatment-free interval of more than six months was prognostic for overall survival (OS). Conclusions. Responses to atezolizumab led to long disease remission in a subset of our patients. The median OS in our real-world population was compromised by a large percentage of patients with poor ECOG performance status (PS). A treatment-free interval from chemotherapy was associated with the longer survival of platinum-treated pa-tients with mUC receiving further atezolizumab.
Keywords: PD-L1 inhibitor, urothelial cancer, bladder, atezolizumab
Published in DiRROS: 23.07.2024; Views: 112; Downloads: 56
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Abstract: Izhodišče: Zdravilo bevacizumab uporabljamo v sklopu primarnega sistemskega zdravljenja napredovalega epitelijskega raka jajčnikov v kombinaciji s paklitakselom in karboplatinom od leta 2013. Namen: Prikazati učinkovitost in varnost zdravljenja z bevacizumabom v redni klinični praksi v sklopu primarnega zdravljenja raka jajčnikov. Metode: V retrospektivno analizo smo vključili bolnice z epitelijskim rakom jajčnikov, ki so se zdravile z bevacizumabom na Onkološkem inštitutu Ljubljana v obdobju od 1. 1. 2013 do 31. 12. 2016. Cilja raziskave sta bila varnost in učinkovitost (preživetje brez ponovitve bolezni, celokupno preživetje) zdravljenja z bevacizumabom. Raziskavo je odobrila etična komisija na Onkološkem inštitutu Ljubljana. Rezultati: V opazovanem obdobju je bilo z bevacizumabom zdravljenih 111 bolnic z napredovalim epitelijskim rakom jajčnikov. Najpogostejši neželeni učinki so bili: bolečine (52 %), krvavitev (45 %), arterijska hipertenzija (44 %). Resne neželene učinke (stopnja 3/4) je imelo 12 % bolnic: venska tromboza/ embolija (3 %), proteinurija (3 %), arterijska hipertenzija (2 %), krvavitev (2 %), bolečine (1 %), fistula (1 %). Mediani čas sledenja je bil 59 mesecev. Mediano preživetje brez ponovitve bolezni je bilo 18 mesecev, mediano celokupno preživetje pa 41 mesecev. Zaključki: Zdravljenje z bevacizumabom v redni klinični praksi je varno in učinkovito ‒ v skladu z do zdaj znanimi rezultati prospektivnih raziskav GOG 218 in ICON 7.
Keywords: rak jajčnikov, epitelijski rak, bevacizumab, kemoterapija
Published in DiRROS: 09.09.2020; Views: 2140; Downloads: 551
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Keywords: rak prostate, nemetastatski rak, kastracija
Published in DiRROS: 11.05.2020; Views: 1876; Downloads: 578
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