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Patients without any factors were assigned to the favorable-risk group (26.5%). Patients with either factor and both factors were assigned to the intermediate-risk group (44.3%), and poor-risk group (29.2%), respectively. Kaplan–Meier curves showed clear discrimination of OS among the risk groups (p &lt; 0.001). The ORR in each group was 35.7% in the favorable-risk group, 27.7% in the intermediate-risk group, and 17.7% in the poor-risk group. Given that the model can be concisely determined at the initiation of pembrolizumab treatment, physicians may be encouraged to consider the risk group for daily practice.</jats:p>","journal":"Cancers","year":2021,"id":625846,"datarank":0.4335557636844247,"base_score":2.8903717578961645,"endowment":2.8903717578961645,"self_citation_contribution":0.4335557636844247,"citation_network_contribution":0.0,"self_endowment_contribution":0.4335557636844247,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":17,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1618729,"name":"Kazumasa Komura","orcid":"0000-0003-4157-1929","position":1,"is_corresponding":false},{"id":1618730,"name":"Wataru Fukuokaya","orcid":null,"position":2,"is_corresponding":false},{"id":628383,"name":"Takahiro Kimura","orcid":"0000-0002-5673-1553","position":3,"is_corresponding":false},{"id":1404153,"name":"Kazuhiro Takahashi","orcid":"0000-0003-1900-4389","position":4,"is_corresponding":false},{"id":1618731,"name":"Yusuke Yano","orcid":null,"position":5,"is_corresponding":false},{"id":1618732,"name":"Kazuki Nishimura","orcid":null,"position":6,"is_corresponding":false},{"id":1110642,"name":"Keita Nakamori","orcid":"0009-0008-5015-7694","position":7,"is_corresponding":false},{"id":1618733,"name":"Yuya Fujiwara","orcid":null,"position":8,"is_corresponding":false},{"id":714528,"name":"Tomohisa Matsunaga","orcid":"0000-0001-5238-2598","position":9,"is_corresponding":false},{"id":509934,"name":"Takeshi Tsutsumi","orcid":"0000-0001-6922-5708","position":10,"is_corresponding":false},{"id":1618734,"name":"Takuya Tsujino","orcid":"0000-0003-1559-1889","position":11,"is_corresponding":false},{"id":246832,"name":"Ryoichi Maenosono","orcid":"0000-0002-9045-5484","position":12,"is_corresponding":false},{"id":368444,"name":"Yuki Yoshikawa","orcid":"0000-0001-8834-5051","position":13,"is_corresponding":false},{"id":1412525,"name":"Kohei Taniguchi","orcid":"0000-0003-0648-1370","position":14,"is_corresponding":false},{"id":1618736,"name":"Tomohito Tanaka","orcid":null,"position":15,"is_corresponding":false},{"id":45298,"name":"Hirofumi Uehara","orcid":"0000-0001-5811-5941","position":16,"is_corresponding":false},{"id":1618737,"name":"Hajime Hirano","orcid":null,"position":17,"is_corresponding":false},{"id":1618738,"name":"Hayahito Nomi","orcid":null,"position":18,"is_corresponding":false},{"id":1618739,"name":"Kiyoshi Takahara","orcid":null,"position":19,"is_corresponding":false},{"id":1184014,"name":"Teruo Inamoto","orcid":"0000-0002-1351-1315","position":20,"is_corresponding":false},{"id":123658,"name":"Shin Egawa","orcid":null,"position":21,"is_corresponding":false},{"id":246835,"name":"Haruhito Azuma","orcid":"0000-0001-5497-1679","position":22,"is_corresponding":false},{"id":1618728,"name":"Taizo Uchimoto","orcid":null,"position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Risk Classification for Overall Survival by the Neutrophil–Lymphocyte Ratio and the Number of Metastatic Sites in Patients Treated with Pembrolizumab—A Multicenter Collaborative Study in Japan","abstract":"<jats:p>Pembrolizumab has emerged as the new standard of care in patients with platinum-refractory metastatic urothelial carcinoma (mUC), whereas the optimal risk stratification to predict survival outcomes is still controversial. We examined a risk model for overall survival (OS) in mUC treated with pembrolizumab using our multi-institutional dataset (212 patients). The median age was 72 years old. Median OS from the initiation of pembrolizumab treatment was 11.7 months. The objective response rate (ORR) was 26.4%. On multivariate analysis, multiple metastatic sites and an NLR &gt; 3.50 at the initiation of pembrolizumab treatment were identified as independent predictors for OS. We next developed a risk model using those two predictors. Patients without any factors were assigned to the favorable-risk group (26.5%). Patients with either factor and both factors were assigned to the intermediate-risk group (44.3%), and poor-risk group (29.2%), respectively. Kaplan–Meier curves showed clear discrimination of OS among the risk groups (p &lt; 0.001). The ORR in each group was 35.7% in the favorable-risk group, 27.7% in the intermediate-risk group, and 17.7% in the poor-risk group. 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