Atezolizumab in platinum-treated locally advanced or metastatic urothelial carcinoma: Post-progression outcomes from the phase II IMvigor210 study

Andrea Necchi, R. W. Joseph, Y. Loriot, J. Hoffman-Censits, J. L. Perez-Gracia, D. P. Petrylak, C. L. Derleth, D. Tayama, Q. Zhu, B. Ding, C. Kaiser, J. E. Rosenberg

Research output: Contribution to journalArticle

42 Scopus citations

Abstract

Background: Conventional criteria for tumor progression may not fully reflect the clinical benefit of immunotherapy or appropriately guide treatment decisions. The phase II IMvigor210 study demonstrated the efficacy and safety of atezolizumab, a programmed death-ligand 1-directed antibody, in patients with platinum-treated locally advanced or metastatic urothelial carcinoma. Patients could continue atezolizumab beyond Response Evaluation Criteria In Solid Tumors (RECIST) v1.1 progression at the investigator's discretion: this analysis assessed post-progression outcomes in these patients. Patients and methods: Patients were treated with atezolizumab 1200mg i.v. every 3 weeks until loss of clinical benefit. Efficacy and safety outcomes in patients who experienced RECIST v1.1 progression and did, or did not, continue atezolizumab were analyzed descriptively. Results: In total, 220 patients who experienced progression from the overall cohort (n=310) were analyzed: 137 continued atezolizumab for ≥1 dose after progression, 19 received other systemic therapy, and 64 received no further systemic therapy. Compared with those who discontinued, patients continuing atezolizumab beyond progression were more likely to have had a baseline Eastern Cooperative Oncology Group performance status of 0 (43.1% versus 31.3%), less likely to have had baseline liver metastases (27.0% versus 41.0%), and more likely to have had an initial response to atezolizumab (responses in 11.7% versus 1.2%). Five patients (3.6%) continuing atezolizumab after progression had subsequent responses compared with baseline measurements. Median post-progression overall survival was 8.6 months in patients continuing atezolizumab, 6.8 months in those receiving another treatment, and 1.2 months in those receiving no further treatment. Atezolizumab exposure-adjusted adverse event frequencies were generally similar before and following progression. Conclusion: In this single-arm study, patients who continued atezolizumab beyond RECIST v1.1 progression derived prolonged clinical benefit without additional safety signals. Identification of patients most likely to benefit from atezolizumab beyond progression remains an important challenge in the management of metastatic urothelial carcinoma.

Original languageEnglish (US)
Pages (from-to)3044-3050
Number of pages7
JournalAnnals of Oncology
Volume28
Issue number12
DOIs
StatePublished - Dec 1 2017

Keywords

  • Atezolizumab
  • Immunotherapy
  • PD-L1
  • Post-progression outcomes
  • Programmed death-ligand 1
  • Urothelial cancer

ASJC Scopus subject areas

  • Hematology
  • Oncology

Fingerprint Dive into the research topics of 'Atezolizumab in platinum-treated locally advanced or metastatic urothelial carcinoma: Post-progression outcomes from the phase II IMvigor210 study'. Together they form a unique fingerprint.

  • Cite this

    Necchi, A., Joseph, R. W., Loriot, Y., Hoffman-Censits, J., Perez-Gracia, J. L., Petrylak, D. P., Derleth, C. L., Tayama, D., Zhu, Q., Ding, B., Kaiser, C., & Rosenberg, J. E. (2017). Atezolizumab in platinum-treated locally advanced or metastatic urothelial carcinoma: Post-progression outcomes from the phase II IMvigor210 study. Annals of Oncology, 28(12), 3044-3050. https://doi.org/10.1093/annonc/mdx518