Summary
This final analysis of the IMvigor210 trial demonstrates that atezolizumab monotherapy (anti-PD-L1) achieved clinically meaningful but modest efficacy in metastatic urothelial carcinoma, with response rates of 23.5% in treatment-naïve patients ineligible for cisplatin and 16.5–19.7% in previously treated patients, and durable responses in a subset of patients with higher PD-L1 expression. Median overall survival was 16.3 months in the untreated cohort and 7.9 months in the previously treated cohort, with manageable safety profile (21.8% and 18.7% grade 3/4 adverse events respectively) and no new safety signals during extended follow-up.
UK applicability
This trial enrolled international patients with metastatic urothelial carcinoma and is directly relevant to UK oncology practice. The findings support consideration of atezolizumab as a treatment option for eligible patients with metastatic UC, particularly those ineligible for cisplatin-based chemotherapy, though modest response rates suggest patient selection and biomarker-driven approaches remain important.
Key measures
Objective response rate (ORR) per RECIST 1.1 and modified RECIST; median overall survival (OS); grade 3/4 treatment-related adverse events; efficacy stratified by PD-L1 tumour-infiltrating immune cell (IC) status
Outcomes reported
The study reported objective response rates (ORR), overall survival (OS), and treatment-related adverse events in patients with metastatic urothelial carcinoma receiving atezolizumab monotherapy across two cohorts (treatment-naïve ineligible for cisplatin and previously platinum-treated patients).
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