BACKGROUND Atezolizumab, a programmed-death ligand-1 (PD-L1) inhibitor, is a novel treatment option for patients with metastatic urothelial cancer (mUC). Clinical prognostic factors, survival outcomes, and the safety of patients with mUC treated with atezolizumab, in a real-world setting, were investigated. PATIENTS AND METHODS 62 patients with mUC, treated at the Institute of Oncology Ljubljana between May 8th 2018 and Dec 31st 2019, were included. Response rates and immune-related adverse events (irAE) were collected. Progression-free survival and overall survival times were assessed using the Kaplan-Meier method. The Cox proportional hazards model was applied to identify the factors affecting survival. RESULTS Of 62 patients, five (8.1%) have not yet been evaluated and 20 (32%) died prior to the first radiographic evaluation. We observed clinical benefit in 19 (33%), objective response in 12 (21%), and complete response in five (9%) patients. Median overall survival for the whole population was 6.8 (95% CI, 2.6-11.0), for platinum-naïve 8.7 (95% CI: 0.8-16.5), and for the platinum-treated group 6.8 (95% CI, 3.7-10) months. At the 5.8 (0.3-23.1) month median follow-up, the median duration of the response was not reached. IrAE occurred in 20 (32%) patients and seven (11%) of them discontinued the treatment. Multivariate analysis in platinum-treated patients showed that a treatment-free interval of more than six months was prognostic for overall survival (OS). CONCLUSIONS Responses to atezolizumab led to long disease remission in a subset of our patients. The median OS in our real-world population was compromised by a large percentage of patients with poor ECOG performance status (PS). A treatment-free interval from chemotherapy was associated with the longer survival of platinum-treated patients with mUC receiving further atezolizumab.

中文翻译：

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在实际操作中，使用阿特珠单抗治疗的转移性尿路上皮癌患者的预后是基于铂类化学疗法的疾病预后。

背景技术Atezolizumab是一种编程性死亡配体1（PD-L1）抑制剂，是转移性尿路上皮癌（mUC）患者的一种新型治疗选择。在真实环境中，研究了使用atezolizumab治疗的mUC患者的临床预后因素，生存结果和安全性。患者与方法纳入了在卢布尔雅那肿瘤研究所（Institute of Ljubljana）于2018年5月8日至2019年12月31日期间接受治疗的62例mUC患者。收集反应率和免疫相关不良事件（irAE）。使用Kaplan-Meier方法评估无进展生存期和总生存时间。应用Cox比例风险模型确定影响生存的因素。结果62例患者中，有5例（8.1％）尚未进行评估，而20例（32％）在首次影像学评估之前死亡。我们观察到19例（33％）的临床获益，12例（21％）的客观缓解以及5例（9％）的完全缓解。总体总体中位生存期为6.8（95％CI，2.6-11.0），未使用白金的8.7（95％CI：0.8-16.5）和接受铂金治疗的组6.8（95％CI，3.7-10） ）个月。在5.8（0.3-23.1）个月的中位随访中，未达到反应的中位持续时间。IrAE发生在20名（32％）患者中，其中七名（11％）中断了治疗。对接受铂金治疗的患者进行的多变量分析显示，超过六个月的无治疗间隔可预示总体生存期（OS）。结论对atezolizumab的反应导致部分患者长期病情缓解。ECOG表现状态（PS）差的患者中，很大比例的患者折中了我们现实世界人口的OS中位数。化疗后的无治疗间隔与铂类药物治疗的mUC接受进一步的atezolizumab的患者更长的生存期相关。