Pulse Brain · Growing Health Evidence Index
Tier 3 — Observational / field trialPeer-reviewed

Risk stratification for the prognosis of patients with chemoresistant urothelial cancer treated with pembrolizumab

Takashi Kobayashi, Katsuhiro Ito, Takahiro Kojima, Minoru Kato, Souhei Kanda, Shingo Hatakeyama, Yoshiyuki Matsui, Yuto Matsushita, Sei Naito, Masanobu Shiga, Makito Miyake, Yusuke Muro, Shotaro Nakanishi, Yoichiro Kato, Tadamasa Shibuya, Tetsutaro Hayashi, Hiroaki Yasumoto, Takashi Yoshida, Motohide Uemura, Rikiya Taoka, Manabu Kamiyama, Osamu Ogawa, Hiroshi Kitamura, Hiroyuki Nishiyama, the Japan Urological Oncology Group

Cancer Science · 2020

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Summary

This multicenter retrospective study developed and validated a simple prognostic model for patients with chemoresistant urothelial carcinoma receiving pembrolizumab immunotherapy. The model stratified patients into low-, intermediate-, and high-risk groups based on four clinicopathological variables, with low-risk patients showing substantially superior overall survival (not yet reached vs. 2.3 months in high-risk group) and response rates (48.3% vs. 10.5%). The validated model demonstrated clinical utility for patient counselling and trial design in this immunotherapy setting.

UK applicability

The findings are clinically relevant to UK oncology practice, as pembrolizumab is used in the UK for advanced urothelial cancer treatment. However, the cohort was Japan-based and may reflect differences in baseline patient characteristics, treatment pathways, and healthcare contexts compared to UK populations; independent validation in UK or European cohorts would strengthen applicability.

Key measures

Overall survival (OS) by risk group; hazard ratios (95% confidence intervals); objective response rates; median OS times in discovery (463 patients) and validation (292 patients) cohorts

Outcomes reported

The study developed and validated a multivariate prognostic model predicting overall survival and objective response rates in patients with chemoresistant urothelial carcinoma treated with pembrolizumab. Risk stratification was based on performance status, site of metastasis, haemoglobin levels, and neutrophil-to-lymphocyte ratio.

Theme
General food systems / other
Subject
Other / interdisciplinary
Study type
Research
Study design
Multicenter retrospective cohort study with independent validation cohort
Source type
Peer-reviewed study
Status
Published
Geography
Japan
System type
Human clinical
DOI
10.1111/cas.14762
Catalogue ID
SNmoh0ds1j-h8cnkp

Topic tags

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