Evidence map›Paper›PMID 40848168›Full record

ArticleInternational urology and nephrology2026

Prognostic role of intramuscular adipose tissue content in patients with urothelial carcinoma treated with pembrolizumab.

Fumihiro Nishimura, Kentaro Oniki, Atsuhiro Yamashita, Keiichi Honda, Kenji Kawata, Tomoko Ushijima, Shinsuke Hamada, Shigeyuki Miyamura, Junji Saruwatari

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Article in International urology and nephrology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Fumihiro NishimuraDepartment of Clinical Pharmacy, Kumamoto Chuo Hospital, Kumamoto, Japan. nishimura.fr@gmail.com.
Kentaro OnikiDivision of Pharmacology and Therapeutics, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan.
Atsuhiro YamashitaDepartment of Diagnostic Radiology, Kumamoto Chuo Hospital, Kumamoto, Japan.
Keiichi HondaDepartment of Diagnostic Radiology, Kumamoto Chuo Hospital, Kumamoto, Japan.
Kenji KawataDepartment of Diagnostic Radiology, Kumamoto Chuo Hospital, Kumamoto, Japan.
Tomoko UshijimaDepartment of Clinical Pharmacy, Kumamoto Chuo Hospital, Kumamoto, Japan.
Shinsuke HamadaDepartment of Urology, Kumamoto Chuo Hospital, Kumamoto, Japan.
Shigeyuki MiyamuraFaculty of Pharmaceutical Sciences, Sojo University, Kumamoto, Japan.
Junji SaruwatariDivision of Pharmacology and Therapeutics, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPembrolizumab is a standard treatment for previously treated advanced urothelial carcinoma (UC); however, individual differences in treatment responses remain a significant problem. This study aimed to evaluate the prognostic factors, particularly muscle mass, and quality, in patients with UC receiving pembrolizumab.

methodsThis retrospective study included 56 patients with UC treated with pembrolizumab between May 2017 and December 2024. The influence of neutrophil-to-lymphocyte ratio (NLR), albumin-bilirubin (ALBI) score, psoas major index, and intramuscular adipose tissue content (IMAC) on progression-free survival (PFS) and overall survival (OS) was investigated. Survival analysis was performed using the Kaplan-Meier method, and time-dependent Cox proportional hazards models were used to identify the prognostic factors for PFS and OS.

resultsThe median follow-up period was 24.3 months (range: 0.7-61.2 months). Multivariable analysis identified low IMAC [hazard ratio (HR) 0.884, 95% confidence interval (CI), 0.804 - 0.971; p = 0.010] and low NLR (HR 0.405, 95% CI, 0.192 - 0.856; p = 0.018) as independent prognostic factors for prolonged PFS. Similarly, a low NLR (HR 0.231, 95% CI, 0.092 - 0.578; p = 0.002) was significantly associated with improved OS, and the presence of liver metastasis (HR 3.037, 95% CI, 1.061 - 8.694; p = 0.038) was identified as a poor prognostic factor.

conclusionsThis study suggested that IMAC and NLR may serve as potential prognostic biomarkers for patients with UC treated with pembrolizumab. The evaluation of muscle quality and inflammatory markers could contribute to improved risk stratification and personalized treatment strategies for immunotherapy.

Indexed as

Adipose TissueAntibodies, Monoclonal, HumanizedAntineoplastic Agents, ImmunologicalCarcinoma, Transitional CellUrinary Bladder NeoplasmsUrologic NeoplasmsAgedAged, 80 and overFemaleHumansMaleMiddle AgedPrognosisRetrospective StudiesAntibodies, Monoclonal, HumanizedAntineoplastic Agents, ImmunologicalpembrolizumabImmune checkpoint inhibitorIntramuscular adipose tissue contentNeutrophil-to-lymphocyte ratioPrognostic biomarkerUrothelial carcinoma

Identifiers

PMID40848168

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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.