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Antihistamines are associated with improvement for patients with metastatic urothelial carcinoma receiving Tecentriq.
Antihistamines are associated with improved progression-free survival, cancer-specific survival and overall survival in metastatic urothelial carcinoma patients treated with Tecentriq.
Antihistamines are associated with improvements in progression and survival for patients with metastatic urothelial carcinoma (mUC) receiving Tecentriq (atezolizumab), research has shown.
Researchers, drawing on data from 896 patients from the phase 2 IMvigor210 trial and phase 3 IMvigor211 trial, published their findings in Urologic Oncology: Seminars and Original Investigations. They found that at two years, the overall survival (OS), cancer-specific survival (CSS) and progression-free survival (PFS) probabilities were 46%, 48% and 23%, respectively, among patients who received antihistamines and were 23%, 32% and 13% for those who did not.
After excluding patients who experienced immune-oncology-related side effects, researchers found a 22% reduction in the risk of cancer-specific death and a 29% reduction in the risk of death from any cause.
The median follow-up time was 17.7 months for patients receiving antihistamines and 7.7 months for patients who did not receive antihistamines.
Overall survival: the time that a patient lives, regardless of disease status.
Cancer-specific survival: the time from the start of treatment until death from cancer.
Progression-free survival: the time that a patient lives without their disease spreading or worsening.
“In this study we investigated the impact of antihistamines on oncological outcomes among patients with [metastatic urothelial carcinoma] treated with second line [Tecentriq] in two randomized clinical trials. We found that patients that received antihistamines concomitant to [immune-oncology] had longer OS, CSS and PFS relative to individuals who did not receive antihistamine medications,” wrote Dr. Giuseppe Fallara and colleagues in the study.
Fallara is a urologist in the Department of Urology at the IRCCS European Institute of Oncology in Milan, Italy.
Among patients who received antihistamines, the median OS was 17.7 months, versus 8.1 months for those who did not receive antihistamines. Likewise, the median PFS times were 4.9 and 2.3 months and the CSS times were 22.8 and 9.3 months, respectively.
Patients with locally advanced or mUC face generally poor prognoses, with a five-year overall survival of approximately 6%, researchers stated.
However, they noted that there are previous data to suggest that antihistamines may improve cancer outcomes, particularly when administered in conjunction with immunotherapy, by reversing T cell dysfunction.
Tecentriq, a type of immunotherapy known as an immune checkpoint inhibitor, binds to the protein PD-L1 on the surface of some cancer cells, which prevents cancer cells from suppressing the immune system, according to the National Cancer Institute.
Of the 896 patients who data were 155, or 17%, used antihistamines during the two trials in question. Researchers reported that overall, 645 patients died of cancer-related causes and 59 died of other causes. Seven hundred patients experienced disease progression while on treatment.
Fallara and his colleagues acknowledged that their study had a number of limitations, including the fact that researchers did not have granular data regarding the timing, duration, type of antihistamine and reasons for antihistamine use.
“In conclusion, using individual patient data from the IMvigor210 and 211 trials, we found that concomitant use of antihistamines was associated with prolonged progression-free, cancer-specific and overall survival in patients treated with [Tecentriq],” Fallara and colleagues wrote. “Our results showed a positive association between antihistamines use and oncologic outcomes in patients with mUC treated with [immunotherapy]. This effect deserves further prospective investigation ideally with a randomized controlled trial of antihistamine versus no antihistamine use.”
Reference:
“Concomitant antihistamine administration is associated with improved survival outcomes in patients with locally advanced or metastatic urothelial carcinoma treated with atezolizumab. Analysis of individual participant data from IMvigor210 and IMvigor211” by Dr. Giuseppe Fallara et al., Urologic Oncology: Seminars and Original Investigations.
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