恩佛替姆威多汀与铂复发在铂、美罗华后晚期尿路上皮癌的比较：一项多中心倾向评分匹配研究。
Enfortumab vedotin versus platinum rechallenge in post-platinum, post-pembrolizumab advanced urothelial carcinoma: A multicenter propensity score-matched study.
发表日期：2023 Sep 22
作者：
Satoru Taguchi, Taketo Kawai, Yoshiki Ambe, Kenjiro Kishitani, Kazuma Sugimoto, Jimpei Miyakawa, Yu Nakamura, Michio Noda, Tomoyuki Kaneko, Jun Kamei, Daisuke Obinata, Kenya Yamaguchi, Shigenori Kakutani, Yoshitsune Furuya, Yujiro Sato, Yukari Uemura, Yoshiyuki Akiyama, Yuta Yamada, Yusuke Sato, Daisuke Yamada, Yutaka Enomoto, Hiroaki Nishimatsu, Tetsuya Fujimura, Hiroshi Fukuhara, Tohru Nakagawa, Satoru Takahashi, Haruki Kume
来源：
Immunity & Ageing
摘要：
2021年，恩法替莫（Enfortumab vedotin，EV）在EV-301试验中显示其在白金药物和包括pembrolizumab在内的免疫检查点抑制剂后的后期治疗中，优于非白金药物化疗，获得了晚期尿路上皮癌（UC）的批准。然而，在该情况下，尚未有研究将EV与再次采用白金药物化疗（即“白金药物再挑战”）进行比较。总共有283名患者在2018年至2023年期间接受了白金药物化疗后的pembrolizumab治疗。其中，41名患者和25名患者在pembrolizumab后作为后期治疗分别接受了EV和白金药物再挑战。在排除了两名未进行影像评估的EV患者后，我们使用倾向性评分匹配（PSM）比较了EV组（n=39）和白金药物再挑战组（n=25）之间的进展生存期（PFS）和总生存期（OS）等肿瘤学结果。对原始数据（n=64）的分析显示两组患者的基线特征没有显著差异。EV组的PFS（5个月）和OS（11个月）与白金药物再挑战组（分别为8个月和12个月）相当。经过PSM（n=36）后，两组之间的基线特征更加平衡，EV组的PFS（未达到）和OS（未达到）与白金药物再挑战组（分别为8个月和11个月）相当。EV和白金药物再挑战在肿瘤学结果上表现出相当的效果，即使在PSM后也是如此，因此两种治疗方案都可作为白金药物和pembrolizumab后的晚期UC有效的治疗选择。© 2023 The Japanese Urological Association.
Enfortumab vedotin (EV) was approved for advanced urothelial carcinoma (UC) in 2021 after the EV-301 trial showed its superiority to non-platinum-based chemotherapy as later-line treatment after platinum-based chemotherapy and immune checkpoint inhibitors including pembrolizumab. However, no study has compared EV with rechallenging platinum-based chemotherapy (i.e., "platinum rechallenge") in that setting.In total, 283 patients received pembrolizumab for advanced UC after platinum-based chemotherapy between 2018 and 2023. Of them, 41 and 25 patients received EV and platinum rechallenge, respectively, as later-line treatment after pembrolizumab. After excluding two patients with EV without imaging evaluation, we compared oncological outcomes, including progression-free survival (PFS) and overall survival (OS), between the EV (n = 39) and platinum rechallenge groups (n = 25) using propensity score matching (PSM).Analyses on crude data (n = 64) showed no significant differences between the two groups regarding patients' baseline characteristics. PFS (5 months) and OS (11 months) in the EV group were comparable to those (8 and 12 months, respectively) in the platinum rechallenge group. After PSM (n = 36), the baseline characteristics between the two groups became more balanced, and PFS (not reached) and OS (not reached) in the EV group were comparable to those (8 and 11 months, respectively) in the platinum rechallenge group.EV and platinum rechallenge showed equivalent oncological outcomes, even after PSM, and both treatments should therefore be effective treatment options for post-platinum, post-pembrolizumab advanced UC.© 2023 The Japanese Urological Association.