Real-world outcomes of pembrolizumab for platinum-refractory advanced urothelial carcinoma: Efficacy, safety, and evidence for trial-unfit patients

Int J Urol. 2023 Sep;30(9):696-703. doi: 10.1111/iju.15101. Epub 2022 Dec 9.

Abstract

Pembrolizumab, monoclonal antibody targeting programmed cell death 1, is widely used for platinum-refractory urothelial carcinoma (UC) patients. Although the survival benefit of pembrolizumab was proven in the well-designed phase III trial, these data represent only a part of patients due to strictly defined eligibility criteria. The patients' characteristics in the clinical practice are much more heterogenous than those of trial participants. The real-world experience is useful to validate the trial result and find suitable candidates for the treatment. Similarly, real-world data plays a significant role in addressing the efficacy and safety of special populations, such as poor performance status or older patients. This review summarizes the real-world evidence on pembrolizumab for platinum-refractory UCs and discusses the clinical risk factors and efficacy for trial-ineligible patients.

Keywords: immune checkpoint inhibitors; pembrolizumab; real-world; retrospective; urothelial carcinoma.

Publication types

  • Review

MeSH terms

  • Carcinoma, Transitional Cell* / drug therapy
  • Carcinoma, Transitional Cell* / pathology
  • Humans
  • Platinum / therapeutic use
  • Urinary Bladder Neoplasms* / drug therapy
  • Urinary Bladder Neoplasms* / pathology
  • Urologic Neoplasms* / pathology

Substances

  • pembrolizumab
  • Platinum