First-line immune checkpoint inhibitor use in cisplatin-eligible patients with advanced urothelial carcinoma: a secular trend analysis.

Abstract	Aim: Standard first-line treatment of advanced urothelial cell carcinoma involves cisplatin-based chemotherapy, with carboplatin or immune checkpoint inhibitor therapy (ICI) reserved for cisplatin-ineligible individuals. Methods: Using a large de-identified electronic health record-derived database of patients with advanced urothelial cell carcinoma in the USA, we examined trends in utilization of first-line systemic therapies in cisplatin-eligible patients from 1 January 2015 to 31 March 2018. Results: Among 1181 cisplatin-eligible patients, the quarterly proportion who received first-line ICI increased from 1 to 42% (ptrend <0.001), while the proportion who received cisplatin-based chemotherapy decreased from 53 to 33% (ptrend = 0.018). Patients receiving ICI were older than those receiving cisplatin (median age: 75 vs 68). Conclusion: Our analysis suggests rising off-label ICI use in cisplatin-eligible individuals, potentially because of ICI's favorable toxicity profile.
Authors	Ravi B Parikh, Emily K Feld, Matthew D Galsky, Blythe Js Adamson, Aaron B Cohen, Shrujal S Baxi, Shimon Ben Boursi, John P Christodouleas, David J Vaughn, Neal J Meropol, Ronac Mamtani
Journal	Future oncology (London, England) (Future Oncol) Vol. 16 Issue 2 Pg. 4341-4345 (Jan 2020) ISSN: 1744-8301 [Electronic] England
PMID	31840537 (Publication Type: Journal Article)
Chemical References	Antibodies, Monoclonal, Humanized B7-H1 Antigen CD274 protein, human PDCD1 protein, human Programmed Cell Death 1 Receptor atezolizumab pembrolizumab Cisplatin
Topics	Aged Aged, 80 and over Antibodies, Monoclonal, Humanized (administration & dosage) Antineoplastic Combined Chemotherapy Protocols (therapeutic use) B7-H1 Antigen (antagonists & inhibitors) Carcinoma, Transitional Cell (drug therapy, immunology, pathology) Cisplatin (administration & dosage) Female Humans Immunotherapy (methods) Male Middle Aged Neoplasm Staging Programmed Cell Death 1 Receptor (antagonists & inhibitors) Treatment Outcome Urologic Neoplasms (drug therapy, immunology, pathology)

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