703P Camrelizumab in combination with gemcitabine plus cisplatin as neoadjuvant therapy for muscle-invasive bladder cancer

Xing, Nianzeng; Han, Songling; Jiang, Junhui; Xu, Wanhai; Shi, Bibo; Ping, Hao; Ji, Zhigang; Ma, Qi; Wang, H.; Chen, S.; Wang, W.; Fan, Xiaoxuan; Zhou, Q.; Zhang, W.

doi:10.1016/j.annonc.2021.08.099

Cited by 2 publications

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“…Most of the included studies were phase II single-arm trials with a total of 22 cohorts, eight of which explored neoadjuvant PD-(L)1 inhibitors alone (two pembrolizumab ( 27 , 34 ), two atezolizumab ( 35 , 36 ), two nivolumab ( 37 , 38 ), one durvalumab ( 39 ), and one avelumab ( 40 )), five cohorts exploring PD-(L)1 inhibitors plus other ICI (three ipilimumab plus nivolumab ( 29 , 37 , 41 ) and two durvalumab plus tremelimumab ( 42 , 43 )), and PD-(L)1 inhibitors plus chemotherapy in 11 cohorts (eight gemcitabine/cisplatin [GC] plus ICI ( 28 , 44 – 50 ), one dose-dense course of methotrexate, vinblastine, doxorubicin, and cisplatin [ddMVAC] plus ICIs ( 51 ), one gemcitabine plus ICI ( 52 ), and one paclitaxel/gemcitabine [PG] plus ICI) ( 40 ). The quality of RCT literature was evaluated using modified Jadad scale for RCTs, and both RCTs were high-quality articles.…”

Section: Resultsmentioning

confidence: 99%

Efficacy and safety of neoadjuvant PD-1 inhibitors or PD-L1 inhibitors for muscle invasive bladder cancer: a systematic review and meta-analysis

Huang,

et al. 2024

Front. Immunol.

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IntroductionThis meta-analysis aims to evaluate the efficacy and safety of neoadjuvant PD-1 inhibitors or PD-L1 inhibitors [PD-(L)1 inhibitors] for muscle-invasive bladder carcinoma (MIBC).Materials and methodsFour databases (Medline, Embase, Web of Science, and 21 CENTRAL) were searched for articles studying neoadjuvant PD-(L)1 inhibitors for MIBC. The search time period was from the establishment of each database to 21 July 2023. Meta-analyses of pCR, pPR, Grade≥ 3 irAEs rate, RFS, and OS were performed.ResultsIn total, 22 studies were included for meta-analysis. The overall pooled pCR of neoadjuvant PD-(L)1 inhibitors was 0.36 (95%CI=0.30–0.42, p=0.00). In subgroup meta-analysis, the pooled PCR of PD-(L)1 inhibitors alone, PD-(L)1 inhibitors plus other ICI, and PD-(L)1 inhibitors plus chemotherapy was 0.27 (95%CI=0.19–0.35, p=0.1), 0.41 (95%CI=0.21–0.62, p=0.01), 0.43 (95%CI=0.35–0.50, p=0.06), respectively. The overall pooled pPR of neoadjuvant PD-(L)1 inhibitors was 0.53 (95%CI=0.46–0.60, p=0.00). In subgroup meta-analysis, the pooled pPR of PD-(L)1 inhibitors alone, PD-(L)1 inhibitors plus other ICI, and PD-(L)1 inhibitors plus chemotherapy was 0.36 (95%CI=0.22–0.51, p=0.01), 0.51 (95%CI=0.39–0.62, p=0.43), and 0.61 (95%CI=0.53–0.69, p=0.01), respectively. Kaplan–Meier curves for OS and RFS were reconstructed, but there was no significant difference among three groups in terms of OS or RFS. The pooled result of Grade≥ 3 irAEs rate for neoadjuvant PD-(L)1 inhibitors was 0.15 (95%CI=0.09–0.22, p=0.00%). In subgroup analysis, the pooled result of Grade≥ 3 irAEs rate for PD-(L)1 inhibitors alone, PD-(L)1 inhibitors plus other ICI, and PD-(L)1 inhibitors plus chemotherapy was 0.07 (95%CI=0.04–0.11, p=0.84), 0.31 (95%CI=0.16–0.47, p=0.06), and 0.17 (95%CI=0.06–0.31, I2 = 71.27%, p=0.01), respectively.ConclusionNeoadjuvant PD-(L)1 inhibitors were feasible and safe for muscle invasive bladder cancer. Compared with PD-(L)1 inhibitors alone, PD-(L)1 inhibitors plus other ICI and PD-(L)1 inhibitors plus chemotherapy were associated with higher pCR and pPR, but higher Grade≥3 irAEs. Kaplan–Meier curves for OS and RFS indicated that neoadjuvant PD-(L)1 inhibitors had an acceptable long-term prognostic, but it was not possible to discern statistical differences between the three neoadjuvant subgroups.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023452437, identifier PROSPERO (CRD42023452437).

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Section: Resultsmentioning

confidence: 99%

Efficacy and safety of neoadjuvant PD-1 inhibitors or PD-L1 inhibitors for muscle invasive bladder cancer: a systematic review and meta-analysis

Huang,

et al. 2024

Front. Immunol.

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Neoadjuvant immunotherapy and chemoimmunotherapy for stage II-III muscle invasive bladder cancer

et al. 2022

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ObjectiveConsidering the striking evidence revealed by immunotherapy in advanced or metastatic bladder cancer, investigators have explored neoadjuvant immunotherapy and chemoimmunotherapy in muscle-invasive bladder cancer (MIBC). Currently, there have been a large number of studies reporting varied efficacy and safety of these approaches. Herein, we pooled the available evidence in terms of oncological outcomes (pathological complete response [pCR] and pathological partial response [pPR]) and safety outcomes (immune-related adverse events [irAEs], treatment-related adverse events [TRAEs]), through a systematic review and meta-analysis.MethodWe searched PubMed, Embase, Cochrane Library, and American Society of Clinical Oncology meeting abstracts to identify relevant studies up to June 2022. Studies were included if they evaluated the neoadjuvant immunotherapy or chemoimmunotherapy in MIBC and reported at least the pCR.ResultsA total of 22 records involving 843 patients were included. For pCR of immunotherapy, the pooled rate of immune checkpoint inhibitor (ICI) monotherapy and dual-ICIs therapy was 24% (95% confidence interval [CI]: 15.3% - 32.8%) and 32.1% (95%CI: 20.6% - 43.7%), respectively. For pCR of chemoimmunotherapy, the overall pooled rate was 42.6% (95% CI: 34.9% - 50.2%). Subgroup of gemcitabine/cisplatin (GC) plus ICI had a pCR rate of 41.7% (95%CI: 35.8% - 47.5%). In terms of safety, the pooled rate of Grade≥3 irAEs was 11.7% (95% CI: 6.5%-16.9%). In subgroup analysis, the Grade≥3 irAEs rate of ICI monotherapy, dual-ICIs therapy, and GC plus ICI therapy was 7.4% (95% CI: 4.3%-10.5%), 30.3% (95% CI: 15.3%-45.3%), and 14.5% (95% CI: 3.5% - 25.4%), respectively. Besides, the pooled Grade≥3 TRAEs rate for chemoimmunotherapy was 32.4% (95% CI: 13.1% - 51.6%).ConclusionNeoadjuvant immunotherapy and chemoimmunotherapy were effective and safe in the treatment of MIBC. Compared to ICI monotherapy, dual-ICIs therapy or chemoimmunotherapy can improve the response rate, while increasing the morbidity of Grade≥ 3 irAEs or Grade≥ 3 TRAEs.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD4202233771.

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703P Camrelizumab in combination with gemcitabine plus cisplatin as neoadjuvant therapy for muscle-invasive bladder cancer

Cited by 2 publications

References 0 publications

Efficacy and safety of neoadjuvant PD-1 inhibitors or PD-L1 inhibitors for muscle invasive bladder cancer: a systematic review and meta-analysis

Efficacy and safety of neoadjuvant PD-1 inhibitors or PD-L1 inhibitors for muscle invasive bladder cancer: a systematic review and meta-analysis

Neoadjuvant immunotherapy and chemoimmunotherapy for stage II-III muscle invasive bladder cancer

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