Τίτλος:
Treatment of Metastatic Urothelial Carcinoma After Previous Cisplatin-based Chemotherapy for Localized Disease: A Retrospective Comparison of Different Chemotherapy Regimens
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Background: Optimal chemotherapy for patients who received cisplatin for localized urothelial carcinoma (UC) and develop metastatic disease is unclear. We compared the efficacy of platinum-based (PBC) versus non–platinum-based (NPBC) first-line chemotherapy for metastasis. Patients and Methods: Data were collected from the Retrospective International Study of Cancers of the Urothelial Tract (RISC), a database of 3024 patients from 28 international academic centers from 2005 to 2012. Patient inclusion criteria included: (1) predominant UC; (2) any primary tumor site; (3) cT2-4, cN0-N2, cM0; (4) prior receipt of perioperative/radiation cisplatin-containing chemotherapy; and (5) receipt of cytotoxic chemotherapy in the first-line metastatic setting. Multivariate Cox proportional hazards models were used to show progression-free survival (PFS) and overall survival (OS) from the first day of chemotherapy for metastatic disease to date of censor. Results: Eligibility criteria was met by 132 patients (n = 74 PBC; n = 58 NPBC). The median OS was 8.13 months (interquartile range, 4.87-16.64 months) and 8.77 months (interquartile range, 4.01-13.49 months) for PBC and NPBC, respectively. Neither OS (hazard ratio [HR], 1.04; 95% confidence interval [CI], 0.64-1.69; P =.87) nor PFS (HR, 0.86; 95% CI, 0.56-1.31; P =.48) differed for PBC versus NPBC. However, for patients who received chemotherapy more than a year after perioperative/radiation chemotherapy, OS was superior for PBC over NPBC (HR, 0.31; 95% CI, 0.10-0.92; P =.03). Conclusions: There is no significant outcome difference between PBC and NPBC in patients with metastatic UC who previously received cisplatin-based chemotherapy for localized disease. However, if over a year has elapsed, return to PBC is associated with superior OS. © 2020 Elsevier Inc.
Συγγραφείς:
Do, O.A.
Ferris, L.A.
Holt, S.K.
Ramos, J.D.
Harshman, L.C.
Plimack, E.R.
Crabb, S.J.
Pal, S.K.
De Giorgi, U.
Ladoire, S.
Baniel, J.
Necchi, A.
Vaishampayan, U.N.
Bamias, A.
Bellmunt, J.
Srinivas, S.
Dorff, T.B.
Galsky, M.D.
Yu, E.Y.
Περιοδικό:
Clinical Genitourinary Cancer
Εκδότης:
HANLEY & BELFUS-ELSEVIER INC
Λέξεις-κλειδιά:
carboplatin; cisplatin; fluorouracil; gemcitabine; pemetrexed; taxane derivative; antineoplastic agent; cisplatin, adult; aged; Article; cancer chemotherapy; cancer control; cancer recurrence; cancer surgery; cancer survival; chemoradiotherapy; comparative effectiveness; comparative study; controlled study; female; human; major clinical study; male; metastasis; multicenter study (topic); multiple cycle treatment; overall survival; progression free survival; retrospective study; transitional cell carcinoma; bladder tumor; transitional cell carcinoma; treatment outcome, Antineoplastic Combined Chemotherapy Protocols; Carcinoma, Transitional Cell; Cisplatin; Humans; Retrospective Studies; Treatment Outcome; Urinary Bladder Neoplasms
DOI:
10.1016/j.clgc.2020.10.006
