The optimal first-line chemotherapy regimen and dose adjustment for cisplatin-unfit patients with advanced, unresectable and/or metastatic urothelial carcinoma remains unclear.
We investigated the association between response to first-line chemotherapy and response to subsequent pembrolizumab treatment.
The response to pembrolizumab after dose-reduced cisplatin plus gemcitabine chemotherapy was inferior to that after carboplatin plus gemcitabine chemotherapy.
The dose-reduced cisplatin plus gemcitabine chemotherapy is not recommended for cis-unfit patients with advanced urothelial carcinoma in the era of immune checkpoint inhibitors.
Patients and Methods
Abbreviations:aUC (advanced, unresectable, and metastatic urothelial carcinoma), CR (complete response), CrCl (creatinine clearance), GC (gemcitabine plus cisplatin combination chemotherapy), GCarbo (gemcitabine plus carboplatin combination chemotherapy), ICD (immunogenic cell death), ICI (immune checkpoint inhibitor), OR (odds ratio), OS (overall survival), PD (progressive disease), PD-1 (programmed cell death protein 1), PD-L1 (programmed death-ligand 1), PR (partial response), SD (stable disease), UC (urothelial carcinoma)
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