417 476
Table 3 – Efficacy of immune checkpoint inhibitors in randomized clinical trials in urological cancer according to tumor PD-L1 expression status
Study
Assessment
of PD-L1 expression
Treatment
PD-L1 expression Patients
(
n
)
Median
OS (mo)
(95% CI)
Median
PFS (mo)
(95% CI)
ORR
(95% CI)
CR
PR
SD
PD
NE
Urothelial cell cancer
Bellmunt et al (2017)
[23]
Combined positive
score of tumor cells and
tumor-infiltrating
immune cells
Pembrolizumab All patients
270
10.3
(8.0–11.8)
2.1
(2.0–2.2)
21.1%
(16.4–26.5)
19
(7%)
38
(14.1%)
47
(17.4%)
131
(48.5%)
35
(13.0%)
PD-L1 10%
74
8.0
(5.0–12.3)
NA
21.6%
(12.9–32.7)
5
(6.8%)
11
(14.9%)
9
(12.2%)
37
(50%)
12
(16.2%)
Chemotherapy All patients
272
7.4
(6.1–8.3)
3.3
(2.3–3.5)
11.4%
(7.9–15.8)
9
(3.3%)
22
(8.1%)
91
(33.5%)
90
(33.1%)
60
(22.1%)
PD-L1 10%
90
5.2
(4.0–7.4)
NA
6.7
(2.5-13.9)
2
(2.2%)
4
(4.4%)
35
(35.6%)
38
(31.1%)
24
(26.7%)
Renal cell cancer
Motzer et al (2015)
[26]
Tumor membrane
expression
Nivolumab
PD-L1
<
1%
276
27.4
(21.4–NR)
NA
NA
NA
NA
NA
NA
NA
PD-L1 1%
94
21.8
(16.5–28.1)
NA
NA
NA
NA
NA
NA
NA
PD-L1
<
5%
326
24.6
(21.4–NR)
NA
NA
NA
NA
NA
NA
NA
PD-L1 5%
44
21.9
(14.0–NR)
NA
NA
NA
NA
NA
NA
NA
Everolimus
PD-L1
<
1%
299
21.2
(17.7–26.2)
NA
NA
NA
NA
NA
NA
NA
PD-L1 1%
87
18.8
(11.9–19.9)
NA
NA
NA
NA
NA
NA
NA
PD-L1
<
5%
345
20.0
(17.7–24.7)
NA
NA
NA
NA
NA
NA
NA
PD-L1 5%
41
18.1
(10.3–NR)
NA
NA
NA
NA
NA
NA
NA
Motzer et al (2015)
[25]
Tumor membrane
expression
Nivolumab
1% or
<
5%
78
18.2
(12.7–26.0)
2.9
(2.1–4.2)
18%
(10.2–28.3)
NA
NA
NA
NA
NA
Nivolumab
5%
29
NR
(13.4–NR)
4.9
(1.4–7.8)
31%
(15.3–50.8)
NA
NA
NA
NA
NA
Choueiri et al (2016)
[24]
Not determined
OS = overall survival; CI = confidence interval; PFS = progression-free survival; ORR = objective response rate; CR = complete response; PR = partial response; SD = stable disease; PD = progressive disease; PD-
L1 = programmed cell death receptor ligand 1; NE = not evaluable; NA = not available; NR = not reached.
E U R O P E A N U R O L O G Y 7 2 ( 2 0 1 7 ) 4 1 1 – 4 2 3
417