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    QoL better with bladder Ca immunotherapy vs. chemo

    Results support agent as new standard of care for previously treated urothelial carcinoma

    Chicago—Patients treated with pembrolizumab (Keytruda) as second-line therapy for advanced urothelial carcinoma (UC) following platinum-based chemotherapy maintain better health-related quality of life (HRQoL) than their counterparts receiving chemotherapy, according to results from the phase III KEYNOTE-045 trial presented at the American Society of Clinical Oncology annual meeting in Chicago. 

    “Health-related quality of life reflects treatment efficacy and safety, and so the quality of life benefits found for pembrolizumab in KEYNOTE-045 are consistent with the superiority it demonstrated for improving overall survival compared with chemotherapy and its more favorable toxicity profile,” said Ronald de Wit, MD, PhD, professor of internal oncology at Erasmus MC Cancer Institute, Rotterdam, the Netherlands.

    Also see: How kidney Ca management strategies compare

    “These reasons collectively render pembrolizumab as a new standard of care for patients with previously treated advanced UC.”

    KEYNOTE-045 randomized 542 patients 1:1 to treatment with the anti-PD-1 humanized monoclonal antibody pembrolizumab, 200 mg every 3 weeks, or the investigator’s choice of chemotherapy with paclitaxel (Abraxane), docetaxel (Taxotere), or vinflunine (Javlor) for up to 2 years.

    Significant survial benefit with treatment

    In the primary endpoint analysis, pembrolizumab demonstrated a statistically significant benefit for improving overall survival compared with chemotherapy (HR 0.73, p=.0022; median 10.3 vs. 7.4 months, respectively). In addition, the pembrolizumab group had a lower rate of treatment-related adverse events than the control group (60.9% vs. 90.2%) and a lower incidence of Grade 3/4 toxicities (15.0% vs 49.4%).

    Quality of life data in the trial were collected using the European Organisation for Research and Treatment of Cancer (EORTC) core 30 quality of life questionnaire (EORTC QLQ-C30), which was completed by patients at cycles 1-4 (weeks 0, 3, 6, and 9) followed by every 2 cycles for up to 1 year and at 30 days after treatment discontinuation.

    Next: QoL compared


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