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Miyake M, Nishimura N, Oda Y, Miyamoto T, Ohmori C, Takamatsu N, Itami Y, Tachibana A, Matsumoto Y, Kiba K, Tomioka A, Yamamoto H, Okajima E, Masaomi K, Sakamoto K, Tomizawa M, Shimizu T, Ohnishi K, Hori S, Morizawa Y, Gotoh D, Nakai Y, Torimoto K, Tanaka N, Fujimoto K. Enfortumab vedotin following platinum-based chemotherapy and immune checkpoint inhibitors for advanced urothelial carcinoma: response, survival and safety analysis from a multicentre real-world Japanese cohort. Jpn J Clin Oncol 2024; 54:329-338. [PMID: 38061911 DOI: 10.1093/jjco/hyad170] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 11/21/2023] [Indexed: 03/12/2024] Open
Abstract
OBJECTIVE Real-world evidence regarding enfortumab vedotin for unresectable or metastatic urothelial carcinoma is scarce, particularly in Japan. We investigated real-world data focusing on patient background, previous treatments, response, survival and adverse events in patients receiving enfortumab vedotin. METHODS A multicentre database was used to register 556 patients diagnosed with metastatic urothelial carcinoma from 2008 to 2023; 34 patients (6.1%) treated with enfortumab vedotin were included. Best radiographic objective responses were evaluated using the Response Evaluation Criteria in Solid Tumors (v1.1) during treatments. Overall survival and progression-free survival were estimated (Kaplan-Meier method). Toxicities were reported according to the Common Terminology Criteria for Adverse Events, version 5.0. The relative dose intensity, which could impact oncological outcomes, was calculated. RESULTS The median number of enfortumab vedotin therapy cycles was 5. The best objective response to enfortumab vedotin was partial response, stable disease and progressive disease in 19 (56%), 5 (15%) and 10 (29%) patients, respectively. The median overall survival and progression-free survival after the first enfortumab vedotin dose were 16 and 9 months, respectively. No significant relationship was observed between survival outcomes after enfortumab vedotin initiation and the enfortumab vedotin relative dose intensity. The median overall survival from first-line platinum-based chemotherapy initiation was 42 months. Twenty-six (76%) patients experienced any grade of enfortumab vedotin-related toxicities; eight (24%) experienced Grades 3-4 toxicities, the most common being skin toxicity (any grade, 47%; Grades 3-4, 12%). CONCLUSIONS Here, we report real-world evidence for enfortumab vedotin therapy in Japan. Tumour responses and safety profiles were comparable with those of clinical trials on this novel treatment.
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Affiliation(s)
- Makito Miyake
- Department of Urology, Nara Medical University, Kashihara, Nara, Japan
| | - Nobutaka Nishimura
- Department of Urology, Nara Medical University, Kashihara, Nara, Japan
- Department of Urology, Hirao Hospital, Kashihara, Nara, Japan
| | - Yuki Oda
- Department of Urology, Nara Medical University, Kashihara, Nara, Japan
| | | | - Chihiro Ohmori
- Department of Urology, Nara Prefecture General Medical Center, Nara, Nara, Japan
| | - Norimi Takamatsu
- Department of Urology, Yamatotakada Municipal Hospital, Yamatotakada, Nara, Japan
| | - Yoshitaka Itami
- Department of Urology, Tane General Hospital, Osaka, Osaka, Japan
| | - Akira Tachibana
- Department of Urology, Hoshigaoka Medical Center, Hirakata, Osaka, Japan
| | | | - Keisuke Kiba
- Department of Urology, Kindai University Nara Hospital, Ikoma, Nara, Japan
| | - Atsushi Tomioka
- Department of Urology, Saiseikai Chuwa Hospital, Sakurai, Nara, Japan
| | - Hiroaki Yamamoto
- Department of Urology, Minami Nara Medical Center, Yoshino, Nara, Japan
| | - Eijiro Okajima
- Department of Urology, Nara City Hospital, Nara, Nara, Japan
| | - Kuwata Masaomi
- Department of Urology, Matsusaka Chuo General Hospital, Matsusaka, Mie, Japan
| | - Keichi Sakamoto
- Department of Urology, Osaka Kaisei Hospital, Osaka, Osaka, Japan
| | - Mitsuru Tomizawa
- Department of Urology, Nara Medical University, Kashihara, Nara, Japan
| | - Takuto Shimizu
- Department of Urology, Nara Medical University, Kashihara, Nara, Japan
| | - Kenta Ohnishi
- Department of Urology, Nara Medical University, Kashihara, Nara, Japan
| | - Shunta Hori
- Department of Urology, Nara Medical University, Kashihara, Nara, Japan
| | - Yosuke Morizawa
- Department of Urology, Nara Medical University, Kashihara, Nara, Japan
| | - Daisuke Gotoh
- Department of Urology, Nara Medical University, Kashihara, Nara, Japan
| | - Yasushi Nakai
- Department of Urology, Nara Medical University, Kashihara, Nara, Japan
| | - Kazumasa Torimoto
- Department of Urology, Nara Medical University, Kashihara, Nara, Japan
| | - Nobumichi Tanaka
- Department of Urology, Nara Medical University, Kashihara, Nara, Japan
- Department of Prostate Brachytherapy, Nara Medical University, Kashihara, Nara, Japan
| | - Kiyohide Fujimoto
- Department of Urology, Nara Medical University, Kashihara, Nara, Japan
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Miyake M, Shimizu T, Oda Y, Tachibana A, Ohmori C, Itami Y, Kiba K, Tomioka A, Yamamoto H, Ohnishi K, Nishimura N, Hori S, Morizawa Y, Gotoh D, Nakai Y, Torimoto K, Fujii T, Tanaka N, Fujimoto K. Switch-maintenance avelumab immunotherapy following first-line chemotherapy for patients with advanced, unresectable or metastatic urothelial carcinoma: the first Japanese real-world evidence from a multicenter study. Jpn J Clin Oncol 2023; 53:253-262. [PMID: 36484294 DOI: 10.1093/jjco/hyac186] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 11/10/2022] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE To develop the first Japanese real-world evidence of switch-maintenance avelumab in advanced, unresectable or metastatic urothelial carcinoma (aUC). METHODS A multicenter-derived database registered 505 patients diagnosed with aUC between 2008 and 2021. Of these, 204 patients (40%) were selected and stratified according to the type of therapy used: maintenance avelumab group (27 [5.3%]), second-line (2 L) pembrolizumab group (103 [20%]) and 2 L cytotoxic chemotherapy group (74 [15%]). The progression-free survival and overall survival from the initiation of following therapy were compared. Tumor response was evaluated based on the Response Evaluation Criteria in Solid Tumors guideline v1.1 during the treatment period. A detailed analysis was performed in the maintenance avelumab group to investigate possible factors associated with response to avelumab therapy. RESULTS The maintenance avelumab group had a longer overall survival, not progression-free survival, compared with the other two treatment groups. The median treatment-free interval between the last dose of first-line (1 L) chemotherapy and the initiation of avelumab therapy was 6 weeks (range, 3-22). Disease control rate of maintenance avelumab therapy in patients with a treatment-free interval of ≤6 weeks was higher than that in patients with a treatment-free interval of >6 weeks (77 vs 40%, P = 0.029). The patients showing objective response to 1 L chemotherapy were less likely to experience tumor relapse (4 of 19) after the initiation of avelumab therapy compared with those showing stable disease (7 of 8). CONCLUSIONS Objective response to 1 L chemotherapy and early induction of maintenance avelumab therapy may be associated with increased benefit from maintenance avelumab therapy.
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Affiliation(s)
- Makito Miyake
- Department of Urology, Nara Medical University, Nara, Japan
| | - Takuto Shimizu
- Department of Urology, Nara Medical University, Nara, Japan
| | - Yuki Oda
- Department of Urology, Yamatotakada Municipal Hospital, Nara, Japan
| | | | - Chihiro Ohmori
- Department of Urology, Nara Prefecture General Medical Center, Nara, Japan
| | - Yoshitaka Itami
- Department of Urology, Nara Prefecture General Medical Center, Nara, Japan
| | - Keisuke Kiba
- Department of Urology, Kindai University Nara Hospital, Nara, Japan
| | - Atsushi Tomioka
- Department of Urology, Saiseikai Chuwa Hospital, Nara, Japan
| | - Hiroaki Yamamoto
- Department of Urology, Minami Nara, General Medical Center, Nara, Japan
| | - Kenta Ohnishi
- Department of Urology, Hoshigaoka Medical Center, Osaka, Japan
| | | | - Shunta Hori
- Department of Prostate Brachytherapy, Nara Medical University, Nara, Japan
| | | | - Daisuke Gotoh
- Department of Urology, Nara Medical University, Nara, Japan
| | - Yasushi Nakai
- Department of Urology, Nara Medical University, Nara, Japan
| | | | - Tomomi Fujii
- Department of Diagnostic Pathology, Nara Medical University, Nara, Japan
| | - Nobumichi Tanaka
- Department of Prostate Brachytherapy, Nara Medical University, Nara, Japan
| | - Kiyohide Fujimoto
- Department of Prostate Brachytherapy, Nara Medical University, Nara, Japan
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Miyake M, Oda Y, Owari T, Iida K, Ohnishi S, Fujii T, Nishimura N, Miyamoto T, Shimizu T, Ohnishi K, Hori S, Morizawa Y, Gotoh D, Nakai Y, Torimoto K, Tanaka N, Fujimoto K. Probiotics enhances anti-tumor immune response induced by gemcitabine plus cisplatin chemotherapy for urothelial cancer. Cancer Sci 2023; 114:1118-1130. [PMID: 36398663 PMCID: PMC9986082 DOI: 10.1111/cas.15666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 11/04/2022] [Accepted: 11/15/2022] [Indexed: 11/19/2022] Open
Abstract
Chemotherapy drugs, such as gemcitabine and cisplatin (GC), are frequently administered to patients with advanced urothelial carcinoma, however the influence of the gut microbiota on their action is unclear. Thus, we investigated the effects of GC on the gut microbiome and determined whether oral supplementation with a probiotics mixture of Lactobacillus casei Shirota and Bifidobacterium breve enhanced the anti-tumor immune response. After subcutaneous inoculation with MBT2 murine bladder cancer cells, syngenic C3H mice were randomly allocated into eight groups. The gut microbiome cluster pattern was altered in both the GC and oral probiotics groups (p = 0.025). Both tumor-bearing conditions (no treatment) and GC chemotherapy influenced Pseudoclostridium, Robinsoniella, Merdimonas, and Phocea in the gut. Furthermore, comparison of the GC-treated and GC + probiotics groups revealed an association of four methyltransferase family enzymes and two short-change fatty acid-related enzymes with oral probiotics use. A significant difference in tumor volume was observed between the GC and GC + probiotics groups at week 2 of treatment. Additionally, decreased recruitment of cancer-associated fibroblasts and regulatory T cells, and activation of CD8+ T cells and dendritic cells were observed in the tumor microenvironment. Our findings reveal the positive effects of a probiotics mixture of Lactobacillus and Bifidobacterium in enhancing anti-tumor effects through the gut-tumor immune response axis. Future clinical trials are needed to evaluate the full benefits of this novel supplement with oral probiotics in patients with advanced urothelial carcinoma.
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Affiliation(s)
- Makito Miyake
- Department of Urology, Nara Medical University, Kashihara, Nara, Japan
| | - Yuki Oda
- Department of Urology, Nara Medical University, Kashihara, Nara, Japan
| | - Takuya Owari
- Department of Urology, Nara Medical University, Kashihara, Nara, Japan
| | - Kota Iida
- Department of Urology, Nara Medical University, Kashihara, Nara, Japan
| | - Sayuri Ohnishi
- Department of Urology, Nara Medical University, Kashihara, Nara, Japan
| | - Tomomi Fujii
- Diagnostic Pathology, Nara Medical University, Kashihara, Nara, Japan
| | | | - Tatsuki Miyamoto
- Department of Urology, Nara Medical University, Kashihara, Nara, Japan
| | - Takuto Shimizu
- Department of Urology, Nara Medical University, Kashihara, Nara, Japan
| | - Kenta Ohnishi
- Department of Urology, Nara Medical University, Kashihara, Nara, Japan
| | - Shunta Hori
- Department of Urology, Nara Medical University, Kashihara, Nara, Japan
| | - Yosuke Morizawa
- Department of Urology, Nara Medical University, Kashihara, Nara, Japan
| | - Daisuke Gotoh
- Department of Urology, Nara Medical University, Kashihara, Nara, Japan
| | - Yasushi Nakai
- Department of Urology, Nara Medical University, Kashihara, Nara, Japan
| | - Kazumasa Torimoto
- Department of Urology, Nara Medical University, Kashihara, Nara, Japan
| | - Nobumichi Tanaka
- Department of Urology, Nara Medical University, Kashihara, Nara, Japan.,Prostate Brachytherapy, Nara Medical University, Kashihara, Nara, Japan
| | - Kiyohide Fujimoto
- Department of Urology, Nara Medical University, Kashihara, Nara, Japan
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Nishimura N, Miyake M, Shimizu T, Matsubara T, Miyamoto T, Sakamoto K, Yamada A, Matsumoto Y, Yoshikawa M, Ichikawa K, Omori C, Maesaka F, Oda Y, Kiba K, Tomioka A, Hosokawa Y, Tanaka M, Otani T, Fujimoto K. First-line pembrolizumab for patients with early relapsing urothelial carcinoma after perioperative chemotherapy: a retrospective analysis of bladder cancer and upper urinary tract cancer. Int J Clin Oncol 2022. [PMID: 36029377 DOI: 10.1007/s10147-022-02230-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 07/31/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND First-line pembrolizumab is available for recurrent disease within 12 months after the receipt of platinum-based perioperative chemotherapy. However, the benefit of first-line pembrolizumab is unclear. This study evaluated the oncological outcome of patients treated with pembrolizumab compared with chemotherapy as first-line therapy for early relapsing disease after the receipt of platinum-based perioperative chemotherapy. METHODS Data from a multicenter study included 454 patients diagnosed with unresectable or metastatic UC from November 2006 to July 2021. We identified patients with early and non-early relapsing disease. Oncological outcomes were evaluated using progression-free survival, overall survival, and survival with disease control. RESULTS Fifty-three patients with early relapsing disease and 15 patients with non-early relapsing disease were identified. Of 53 patients with early relapsing disease, 26 (49.1%) were treated with pembrolizumab and 27 (50.9%) were treated with chemotherapy as first-line therapy. Fifteen patients with non-early relapsing disease were treated with chemotherapy. Early relapsing disease was associated with shorter progression-free survival and overall survival than non-early relapsing disease. Pembrolizumab was associated with longer progression-free survival and survival with disease control than chemotherapy in patients with early relapsing disease. There was no significant difference in overall survival between pembrolizumab and chemotherapy, but overall survival plateau with a long tail was observed in pembrolizumab. CONCLUSIONS First-line pembrolizumab in earlier clinical settings for highly malignant tumors might improve the prognosis of patients with early relapsing disease after the receipt of platinum-based perioperative chemotherapy.
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Nishimura N, Miyake M, Shimizu T, Tachibana A, Tanaka N, Fujimoto K. Efficacy of pembrolizumab rechallenge for metastatic urothelial carcinoma. IJU Case Rep 2022; 5:338-341. [PMID: 36090940 PMCID: PMC9436659 DOI: 10.1002/iju5.12474] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 05/06/2022] [Indexed: 12/04/2022] Open
Abstract
Introduction Before the approval of enfortumab vedotin, no standard treatment was available as the salvage treatment for patients with metastatic urothelial carcinoma who had failed second‐line or later pembrolizumab. Pembrolizumab rechallenge is one of the options for these patients, but there is limited evidence on the effectiveness of pembrolizumab rechallenge. We report three patients with metastatic urothelial carcinoma treated with pembrolizumab rechallenge and discuss rechallenge of immune checkpoint inhibitors in other malignancies. Case presentation This study included three cases treated with pembrolizumab rechallenge with the age of 54 (Case 1), 78 (Case 2), and 67 (Case 3) years old. A complete response to the prior pembrolizumab was observed only in Case 1. However, no patients responded to the pembrolizumab rechallenge. Conclusion Pembrolizumab rechallenge is not recommended in the current clinical setting of metastatic urothelial carcinoma, even for patients who showed complete response to the prior pembrolizumab.
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Affiliation(s)
| | - Makito Miyake
- Department of Urology Nara Medical University Kashihara Nara Japan
| | - Takuto Shimizu
- Department of Urology Saiseikai Chuwa Hospital Sakurai Nara Japan
| | - Akira Tachibana
- Department of Urology Gokeikai Osaka Kansei Hospital Yodogawaku Osaka Japan
| | - Nobumichi Tanaka
- Department of Urology Nara Medical University Kashihara Nara Japan
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Shimizu T, Miyake M, Nishimura N, Inoue K, Fujii K, Iemura Y, Ichikawa K, Omori C, Tomizawa M, Maesaka F, Oda Y, Miyamoto T, Sakamoto K, Kiba K, Tanaka M, Oyama N, Okajima E, Fujimoto K, Hori S, Morizawa Y, Gotoh D, Nakai Y, Torimoto K, Tanaka N, Fujimoto K. Organ-Specific and Mixed Responses to Pembrolizumab in Patients with Unresectable or Metastatic Urothelial Carcinoma: A Multicenter Retrospective Study. Cancers (Basel) 2022; 14:cancers14071735. [PMID: 35406508 PMCID: PMC8997142 DOI: 10.3390/cancers14071735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 03/24/2022] [Accepted: 03/24/2022] [Indexed: 11/16/2022] Open
Abstract
To investigate the organ-specific response and clinical outcomes of mixed responses (MRs) to immune checkpoint inhibitors (ICIs) for unresectable or metastatic urothelial carcinoma (ur/mUC), we retrospectively analyzed 136 patients who received pembrolizumab. The total objective response rate (ORR) and organ-specific ORR were determined for each lesion according to the Response Evaluation Criteria in Solid Tumors version 1.1 as follows: (i) complete response (CR), (ii) partial response (PR), (iii) stable disease (SD), and (iv) progressive disease (PD). Most of the organ-specific ORR was 30−40%, but bone metastasis was only 5%. There was a significant difference in overall survival (OS) between responders and non-responders with locally advanced lesions and lymph node, lung, or liver metastases (HR 9.02 (3.63−22.4) p < 0.0001; HR 3.63 (1.97−6.69), p < 0.0001; HR 2.75 (1.35−5.59), p = 0.0053; and HR 3.17 (1.00−10.0), p = 0.049, respectively). MR was defined as occurring when PD happened in one lesion plus either CR or PR occurred in another lesion simultaneously, and 12 cases were applicable. MR was significantly associated with a poorer prognosis than that of the responder group (CR or PR; HR 0.09 (0.02−0.35), p = 0.004). Patients with bone metastases benefitted less. Care may be needed to treat patients with MR as well as patients with pure PD. Further studies should be conducted in the future.
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Affiliation(s)
- Takuto Shimizu
- Department of Urology, Nara Medical University, Kashihara 634-8522, Japan; (T.S.); (K.I.); (K.S.); (S.H.); (Y.M.); (D.G.); (Y.N.); (K.T.); (K.F.)
| | - Makito Miyake
- Department of Urology, Nara Medical University, Kashihara 634-8522, Japan; (T.S.); (K.I.); (K.S.); (S.H.); (Y.M.); (D.G.); (Y.N.); (K.T.); (K.F.)
- Correspondence: ; Tel.: +81-744-22-3051; Fax: +81-744-22-9282
| | - Nobutaka Nishimura
- Department of Urology, Okanami General Hospital, Iga 518-0842, Japan; (N.N.); (K.F.)
| | - Kuniaki Inoue
- Department of Urology, Nara Medical University, Kashihara 634-8522, Japan; (T.S.); (K.I.); (K.S.); (S.H.); (Y.M.); (D.G.); (Y.N.); (K.T.); (K.F.)
| | - Koyo Fujii
- Department of Urology, Osaka Gyoumeikan Hospital, Osaka 554-0012, Japan;
| | - Yusuke Iemura
- Department of Urology, Hirao Hospital, Kashihara 634-0076, Japan;
| | - Kazuki Ichikawa
- Department of Urology, Takai Hospital, Tenri 632-0372, Japan;
| | - Chihiro Omori
- Department of Urology, Nara Prefecture General Medical Center, Nara 630-8581, Japan;
| | - Mitsuru Tomizawa
- Department of Urology, Yamato Takada Municipal Hospital, Yamato Takada 635-8501, Japan;
| | - Fumisato Maesaka
- Department of Urology, Nara City Hospital, Nara 630-8305, Japan; (F.M.); (E.O.)
| | - Yuki Oda
- Department of Urology, Nara Prefecture Seiwa Medical Center, Ikoma 636-0802, Japan; (Y.O.); (N.O.)
| | - Tatsuki Miyamoto
- Department of Urology, Hoshigaoka Medical Center, Hirakata 573-8511, Japan;
| | - Keiichi Sakamoto
- Department of Urology, Nara Medical University, Kashihara 634-8522, Japan; (T.S.); (K.I.); (K.S.); (S.H.); (Y.M.); (D.G.); (Y.N.); (K.T.); (K.F.)
| | - Keisuke Kiba
- Department of Urology, Kindai University Nara Hospital, Ikoma 630-0293, Japan;
| | - Masahiro Tanaka
- Department of Urology, Osaka Kaisei Hospital, Osaka 532-0003, Japan;
| | - Nobuo Oyama
- Department of Urology, Nara Prefecture Seiwa Medical Center, Ikoma 636-0802, Japan; (Y.O.); (N.O.)
| | - Eijiro Okajima
- Department of Urology, Nara City Hospital, Nara 630-8305, Japan; (F.M.); (E.O.)
| | - Ken Fujimoto
- Department of Urology, Okanami General Hospital, Iga 518-0842, Japan; (N.N.); (K.F.)
| | - Shunta Hori
- Department of Urology, Nara Medical University, Kashihara 634-8522, Japan; (T.S.); (K.I.); (K.S.); (S.H.); (Y.M.); (D.G.); (Y.N.); (K.T.); (K.F.)
| | - Yosuke Morizawa
- Department of Urology, Nara Medical University, Kashihara 634-8522, Japan; (T.S.); (K.I.); (K.S.); (S.H.); (Y.M.); (D.G.); (Y.N.); (K.T.); (K.F.)
| | - Daisuke Gotoh
- Department of Urology, Nara Medical University, Kashihara 634-8522, Japan; (T.S.); (K.I.); (K.S.); (S.H.); (Y.M.); (D.G.); (Y.N.); (K.T.); (K.F.)
| | - Yasushi Nakai
- Department of Urology, Nara Medical University, Kashihara 634-8522, Japan; (T.S.); (K.I.); (K.S.); (S.H.); (Y.M.); (D.G.); (Y.N.); (K.T.); (K.F.)
| | - Kazumasa Torimoto
- Department of Urology, Nara Medical University, Kashihara 634-8522, Japan; (T.S.); (K.I.); (K.S.); (S.H.); (Y.M.); (D.G.); (Y.N.); (K.T.); (K.F.)
| | - Nobumichi Tanaka
- Department of Brachytherapy, Nara Medical University, Kashihara 634-8522, Japan;
| | - Kiyohide Fujimoto
- Department of Urology, Nara Medical University, Kashihara 634-8522, Japan; (T.S.); (K.I.); (K.S.); (S.H.); (Y.M.); (D.G.); (Y.N.); (K.T.); (K.F.)
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Miyake M. Editorial Comment to Association of oncological response between the first-line chemotherapy and subsequent immune checkpoint inhibitors therapy in patients with unresectable or metastatic urothelial carcinoma. Int J Urol 2022; 29:364-365. [PMID: 35028986 DOI: 10.1111/iju.14790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 12/26/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Makito Miyake
- Department of Urology, Nara Medical University, Nara, Japan
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