泌尿癌症的免疫治療在單一中心的經驗：進展與挑戰
王又德1、楊啟瑞1、林精湛2、吳錫金3、黃志平1、葉士芃2、張兆祥1
1中國醫藥大學附設醫院泌尿部
2中國醫藥大學附設醫院內科部
3中國醫藥大學附設醫院北港分院泌尿部
Immunotherapy of Urological Cancer in Single Center Experience: Advances and Challenges
Yu-De Wang1, Che-Rei Yang1, Ching-Chan Lin2, Hsi-Chin Wu3, Chi-Ping Huang1, Shih-Peng Yeh2, Chao-Hsiang Chang1
1 Department of Urology, China Medical University Hospital, Taichung, Taiwan
2 Department of Hematology, China Medical University Hospital, Taichung, Taiwan
3 Department of Urology, China Medical University Beigang Hospital, Yunlin, Taiwan
Purpose:
To evaluate the treatment response of immunotherapy (check point inhibitor) in China Medical University Hospital
Materials and Methods:
We performed a retrospective study in patients who underwent immunotherapy between June 2015 and March 2019. Patient demographic information including age, gender, cancer stage, treatment setting, medication, percent of combination therapy were evaluated. Treatment effect was evaluated by response rate accessed by RECIST criteria, percentage of tumor recurrence and death, and percentage of adverse event.
Results:
There were 17, 5, and 10 patients receiving immunotherapy for upper tract urothelial carcinoma (UTUC), bladder cancer (UBUC), and renal cell carcinoma (RCC) respectively. The median age (IQR) was 67.5(15.75), number of male gender (%) was 21(67.74). The number of stage I-III (%) was 8(25), and stage IV was 24(75). There were 25(78.2%) patients received PD-1 inhibitor and 7(21.8%) patients received PD-L1 inhibitor. The response rate for UTUC, UBUC, and RCC were 23.5%, 0%, and 20% respectively. The response rate for neoadjuvant in urothelial cancer was 100%, and 100% was stable in adjuvant treatment in urothelial cancer. The mean overall survival (SE) for UTUC, UBUC, and RCC was 38.13(6.45), 5.75(1.08), 21(3.67) respectively.
Conclusion:
Checkpoint inhibitor is a novel favorable medication in real world experience. The response rate is promising especially in peri-operative treatment of urothelial carcinoma. However more prospective randomized studies are required.