Evidence map›Paper›PMID 37422731›Full record

ArticleBJU international2024

The immune-related adverse events paradox in locally advanced or metastatic urothelial cancer after atezolizumab immunotherapy: analysis of individual patient data from IMvigor210 and IMvigor211 trials.

Daniele Robesti, Luigi Nocera, Federico Belladelli, Julianne G Schultz, Giuseppe Fallara, Laura Marandino, Daniele Raggi, Francesco Montorsi, Pavlos Msaouel, Andrea Necchi and 1 more

Abstract read
In one paragraph

Article in BJU international, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
2.2field-weighted citation impact, top 12% 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

3 citing papers in PubMed, 7 citations in OpenAlex.

  1. Article
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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

11 authors at 4 institutions in 2 countries.

Daniele RobestiDepartment of Urology, Division of Experimental Oncology, URI - Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy.ORCID 0000-0001-6486-2169
Luigi NoceraDepartment of Urology, Division of Experimental Oncology, URI - Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy.ORCID 0000-0003-3354-8139
Federico BelladelliDepartment of Urology, Division of Experimental Oncology, URI - Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy.
Julianne G SchultzNational Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
Giuseppe FallaraDepartment of Urology, Division of Experimental Oncology, URI - Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy.ORCID 0000-0001-7872-2650
Laura MarandinoDepartment of Oncology, IRCCS Ospedale San Raffaele, Milan, Italy.
Daniele RaggiDepartment of Oncology, IRCCS Ospedale San Raffaele, Milan, Italy.
Francesco MontorsiDepartment of Urology, Division of Experimental Oncology, URI - Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy.ORCID 0000-0002-7267-4181
Pavlos MsaouelDepartment of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.ORCID 0000-0001-6505-8308
Andrea NecchiDepartment of Oncology, IRCCS Ospedale San Raffaele, Milan, Italy.
Alberto MartiniDepartment of Urology, University of Texas MD Anderson Cancer Center, Houston, TX, USA.ORCID 0000-0003-1272-7154
Vita-Salute San Raffaele University · ITIRCCS Ospedale San Raffaele · ITThe University of Texas MD Anderson Cancer Center · USNational Institutes of Health · US

Funding

Tumor Evolution and Metastasis ProgramP30CA016672 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI Scott Kopetz · 1985 to 2026
$290.8M
Advanced Discovery Award by the Kidney Cancer AssociationMD Anderson Khalifa Scholar Award, the Andrew Sabin Family Foundation Fellowship, a Translational Research Partnership Award (KC200096P1)MD Anderson Physician-Scientist AwardNCI NIH HHS P30 CA016672Translational Research Award by the V Foundation
6 · The paper itself

Abstract

objectiveTo investigate the association between immune-related adverse events (irAEs) and oncological outcomes in patients with advanced urothelial cancer receiving immune checkpoint inhibitors (ICIs), and whether the administration of systemic corticosteroids diminishes therapeutic impact. PATIENTS AND

methodsThe association between irAEs occurrence and clinical progression-free survival (PFS), overall survival (OS), and cancer-specific survival (CSS) was tested by means of multivariable Cox or competing-risks regression, when appropriate. Patients experiencing irAEs were further stratified based on systemic corticosteroids administration. A sensitivity analysis was conducted by repeating all the analyses with median time to irAE as landmark point.

resultsWe relied on individual participant data from two prospective trials for advanced urothelial cancer: IMvigor210 and IMvigor211. A total of 896 patients who received atezolizumab for locally advanced or metastatic urothelial cancer were considered. Overall, irAEs were recorded in 195 patients and the median time to irAEs was 64 days. On multivariable analysis, irAEs were inversely associated with the risk of disease progression (hazard ratio [HR] 0.50, 95% confidence interval [CI] 0.40-0.61; P < 0.001), overall mortality (HR 0.51, 95% CI 0.41-0.64; P < 0.001), and cancer-specific mortality (subdistributional HR [sHR] 0.55, 95% CI 0.45-0.72; P < 0.001). Moreover, our results did not refute the supposition that the administration of systemic corticosteroids does not impact oncological outcomes (PFS: HR 0.92, 95% CI 0.62-1.34, P = 0.629; OS: HR 0.86, 95% CI 0.51-1.64, P = 0.613; CSS: sHR 0.90, 95% CI 0.60-1.36, P = 0.630). The sensitivity analysis confirmed our findings.

conclusionsThe development of irAEs while receiving atezolizumab treatment was associated with improved oncological outcomes, namely overall and cancer-specific mortality, and PFS. These findings seem to not be substantially affected by administration of systemic corticosteroids.

Indexed as

Antibodies, Monoclonal, HumanizedCarcinoma, Transitional CellAdrenal Cortex HormonesHumansImmunotherapyProspective StudiesRetrospective StudiesAdrenal Cortex HormonesAntibodies, Monoclonal, Humanizedatezolizumabautoimmune adverse eventsimmunotherapymetastatic diseasesystemic corticosteroidsurothelial cancer

Identifiers

PMID37422731
PMCPMC13065359
OpenAlexW4383679998

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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.