Evidence map›Paper›PMID 33283385›Full record

ArticleCancer science2021

Risk stratification for the prognosis of patients with chemoresistant urothelial cancer treated with pembrolizumab.

Takashi Kobayashi, Katsuhiro Ito, Takahiro Kojima, Minoru Kato, Souhei Kanda, Shingo Hatakeyama, Yoshiyuki Matsui, Yuto Matsushita, Sei Naito, Masanobu Shiga and 15 more

Open access · goldAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Cancer science, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
38citing papers in PubMed, 2 pooled it
8.8field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

38 citing papers in PubMed, 2 syntheses or guidelines pooled it, 72 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Response to First-Line Chemotherapy Predicts Response to Maintenance Avelumab Therapy in Japanese Patients With Advanced Urothelial Carcinoma.International journal of urology : official journal of the Japanese Urological Association · 2025
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  11. Real-world sequential treatment patterns and clinical outcomes among patients with advanced urothelial carcinoma in Japan.International journal of urology : official journal of the Japanese Urological Association · 2024
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

25 authors at 20 institutions in 1 country.

Takashi KobayashiDepartment of Urology, Kyoto University Graduate School of Medicine, Kyoto, Japan.ORCID https://orcid.org/0000-0003-1069-2816
Katsuhiro ItoDepartment of Urology, Ijinkai Takeda General Hospital, Kyoto, Japan.ORCID https://orcid.org/0000-0002-6322-9190
Takahiro KojimaDepartment of Urology, University of Tsukuba, Tsukuba, Japan.
Minoru KatoDepartment of Urology, Osaka City University, Osaka, Japan.
Souhei KandaDepartment of Urology, Akita University, Akita, Japan.
Shingo HatakeyamaDepartment of Urology, Hirosaki University, Hirosaki, Japan.
Yoshiyuki MatsuiDepartment of Urology, National Cancer Center Hospital, Tokyo, Japan.
Yuto MatsushitaDepartment of Urology, Hamamatsu University School of Medicine, Hamamatsu, Japan.
Sei NaitoDepartment of Urology, Faculty of Medicine, Yamagata University, Yamagata, Japan.
Masanobu ShigaDepartment of Urology, University of Tsukuba, Tsukuba, Japan.
Makito MiyakeDepartment of Urology, Nara Medical University, Kashihara, Japan.ORCID https://orcid.org/0000-0001-9503-7356
Yusuke MuroDepartment of Urology, Shizuoka General Hospital, Shizuoka, Japan.
Shotaro NakanishiDepartment of Urology, University of the Ryukyus, Nishihara, Japan.
Yoichiro KatoDepartment of Urology, Iwate Medical University, Morioka, Japan.
Tadamasa ShibuyaDepartment of Urology, Oita University, Yufu, Japan.
Tetsutaro HayashiDepartment of Urology, Hiroshima University, Hiroshima, Japan.
Hiroaki YasumotoDepartment of Urology, Shimane University, Izumo, Japan.
Takashi YoshidaDepartment of Urology, Kansai Medical University, Hirakata, Japan.
Motohide UemuraDepartment of Urology, Osaka University, Suita, Japan.
Rikiya TaokaDepartment of Urology, Kagawa University, Kita, Japan.
Manabu KamiyamaDepartment of Urology, University of Yamanashi, Chuo, Japan.
Osamu OgawaDepartment of Urology, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Hiroshi KitamuraDepartment of Urology, Toyama University, Toyama, Japan.
Hiroyuki NishiyamaDepartment of Urology, University of Tsukuba, Tsukuba, Japan.
Japan Urological Oncology Group
University of Tsukuba · JPKyoto University · JPAkita University · JPHamamatsu University School of Medicine · JPHirosaki University · JPHiroshima University · JPIjinkai Takeda General Hospital · JPIwate Medical University · JPKagawa University · JPKansai Medical University · JPNara Medical University · JPOita University · JPOsaka City University · JPOsaka Gakuin University · JPShimane University · JPShizuoka General Hospital · JPTokyo National Hospital · JPUniversity of the Ryukyus · JPUniversity of Toyama · JPUniversity of Yamanashi · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The use of immune checkpoint inhibitors to treat urothelial carcinoma (UC) is increasing rapidly without clear guidance for validated risk stratification. This multicenter retrospective study collected clinicopathological information on 463 patients, and 11 predefined variables were analyzed to develop a multivariate model predicting overall survival (OS). The model was validated using an independent dataset of 292 patients. Patient characteristics and outcomes were well balanced between the discovery and validation cohorts, which had median OS times of 10.2 and 12.5 mo, respectively. The final validated multivariate model was defined by risk scores based on the hazard ratios (HRs) of independent prognostic factors including performance status, site of metastasis, hemoglobin levels, and the neutrophil-to-lymphocyte ratio. The median OS times (95% confidence intervals [CIs]) for the low-, intermediate-, and high-risk groups (discovery cohort) were not yet reached (NYR) (NYR-19.1), 6.8 mo (5.8-8.9), and 2.3 mo (1.2-2.6), respectively. The HRs (95% CI) for OS in the low- and intermediate-risk groups vs the high-risk group were 0.07 (0.04-0.11) and 0.23 (0.15-0.37), respectively. The objective response rates for in the low-, intermediate-, and high-risk groups were 48.3%, 28.8%, and 10.5%, respectively. These differential outcomes were well reproduced in the validation cohort and in patients who received pembrolizumab after perioperative or first-line chemotherapy (N = 584). In conclusion, the present study developed and validated a simple prognostic model predicting the oncological outcomes of pembrolizumab-treated patients with chemoresistant UC. The model provides useful information for external validation, patient counseling, and clinical trial design.

Indexed as

AdultAgedAged, 80 and overAntibodies, Monoclonal, HumanizedAntineoplastic Agents, ImmunologicalDrug Resistance, NeoplasmFemaleHumansMaleMiddle AgedPrognosisProgression-Free SurvivalProportional Hazards ModelsRetrospective StudiesRisk AssessmentSalvage TherapyAntibodies, Monoclonal, HumanizedAntineoplastic Agents, Immunologicalpembrolizumabmetastatic urothelial cancermultivariate risk stratification modeloverall survivalpembrolizumabprognostic variables

Identifiers

PMID33283385
PMCPMC7893997
OpenAlexW3113007489

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.