Pretreatment clinical and hematologic prognostic factors of metastatic urothelial carcinoma treated with pembrolizumab: a systematic review and meta-analysis
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Pretreatment clinical and hematologic prognostic factors of metastatic urothelial carcinoma treated with pembrolizumab: a systematic review and meta-analysis. / Yanagisawa, Takafumi; Mori, Keiichiro; Katayama, Satoshi; Mostafaei, Hadi; Quhal, Fahad; Laukhtina, Ekaterina; Rajwa, Pawel; Motlagh, Reza Sari; Aydh, Abdulmajeed; König, Frederik; Grossmann, Nico C; Pradere, Benjamin; Miki, Jun; Kimura, Takahiro; Egawa, Shin; Shariat, Shahrokh F.
in: INT J CLIN ONCOL, Jahrgang 27, Nr. 1, 01.2022, S. 59-71.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Review › Forschung
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TY - JOUR
T1 - Pretreatment clinical and hematologic prognostic factors of metastatic urothelial carcinoma treated with pembrolizumab: a systematic review and meta-analysis
AU - Yanagisawa, Takafumi
AU - Mori, Keiichiro
AU - Katayama, Satoshi
AU - Mostafaei, Hadi
AU - Quhal, Fahad
AU - Laukhtina, Ekaterina
AU - Rajwa, Pawel
AU - Motlagh, Reza Sari
AU - Aydh, Abdulmajeed
AU - König, Frederik
AU - Grossmann, Nico C
AU - Pradere, Benjamin
AU - Miki, Jun
AU - Kimura, Takahiro
AU - Egawa, Shin
AU - Shariat, Shahrokh F
N1 - © 2021. The Author(s).
PY - 2022/1
Y1 - 2022/1
N2 - Pembrolizumab is the standard for the first and second lines in treating metastatic urothelial carcinoma (UC). This systematic review and meta-analysis aimed to assess the value of pretreatment clinical characteristics and hematologic biomarkers for prognosticating response to pembrolizumab in patients with metastatic UC. PUBMED®, Web of Science™, and Scopus® databases were searched for articles published before May 2021 according to the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analyses) statement. Studies were deemed eligible if they evaluated overall survival (OS) in patients with metastatic urothelial carcinoma treated with pembrolizumab and pretreatment clinical characteristics or laboratory examination. Overall, 13 studies comprising 1311 patients were eligible for the meta-analysis. Several pretreatment patients' demographics and hematologic biomarkers were significantly associated with worse OS as follows: Eastern Cooperative Oncology Group Performance Status (ECOG-PS) ≥ 2 (Pooled hazard ratio [HR]: 3.24, 95% confidence interval [CI] 2.57-4.09), presence of visceral metastasis (Pooled HR: 1.84, 95% CI 1.42-2.38), presence of liver metastasis (Pooled HR: 4.23, 95% CI 2.18-8.20), higher neutrophil-lymphocyte ratio (NLR) (Pooled HR: 1.29, 95% CI 1.07-1.55) and, higher c-reactive protein (CRP) (Pooled HR: 2.49, 95% CI 1.52-4.07). Metastatic UC patients with poor PS, liver metastasis, higher pretreatment NLR and/or CRP have a worse survival despite pembrolizumab treatment. These findings might help to guide the prognostic tools for clinical decision-making; however, they should be interpreted carefully, owing to limitations regarding the retrospective nature of primary data.
AB - Pembrolizumab is the standard for the first and second lines in treating metastatic urothelial carcinoma (UC). This systematic review and meta-analysis aimed to assess the value of pretreatment clinical characteristics and hematologic biomarkers for prognosticating response to pembrolizumab in patients with metastatic UC. PUBMED®, Web of Science™, and Scopus® databases were searched for articles published before May 2021 according to the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analyses) statement. Studies were deemed eligible if they evaluated overall survival (OS) in patients with metastatic urothelial carcinoma treated with pembrolizumab and pretreatment clinical characteristics or laboratory examination. Overall, 13 studies comprising 1311 patients were eligible for the meta-analysis. Several pretreatment patients' demographics and hematologic biomarkers were significantly associated with worse OS as follows: Eastern Cooperative Oncology Group Performance Status (ECOG-PS) ≥ 2 (Pooled hazard ratio [HR]: 3.24, 95% confidence interval [CI] 2.57-4.09), presence of visceral metastasis (Pooled HR: 1.84, 95% CI 1.42-2.38), presence of liver metastasis (Pooled HR: 4.23, 95% CI 2.18-8.20), higher neutrophil-lymphocyte ratio (NLR) (Pooled HR: 1.29, 95% CI 1.07-1.55) and, higher c-reactive protein (CRP) (Pooled HR: 2.49, 95% CI 1.52-4.07). Metastatic UC patients with poor PS, liver metastasis, higher pretreatment NLR and/or CRP have a worse survival despite pembrolizumab treatment. These findings might help to guide the prognostic tools for clinical decision-making; however, they should be interpreted carefully, owing to limitations regarding the retrospective nature of primary data.
KW - Antibodies, Monoclonal, Humanized/therapeutic use
KW - Carcinoma, Transitional Cell/drug therapy
KW - Humans
KW - Prognosis
KW - Retrospective Studies
KW - Urinary Bladder Neoplasms/drug therapy
U2 - 10.1007/s10147-021-02061-0
DO - 10.1007/s10147-021-02061-0
M3 - SCORING: Review article
C2 - 34757531
VL - 27
SP - 59
EP - 71
JO - INT J CLIN ONCOL
JF - INT J CLIN ONCOL
SN - 1341-9625
IS - 1
ER -
