Τίτλος:
Cisplatin-based combination chemotherapy in septuagenarians with metastatic urothelial cancer
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Purpose: Cisplatin-based chemotherapy is standard first-line treatment for metastatic urothelial carcinoma. However, cisplatin is frequently avoided in elderly patients due to concerns regarding toxicities. We analyzed the efficacy, and tolerability, of cisplatin-based chemotherapy in elderly patients. Methods: Individual patient data were pooled from 8 phase II and III trials evaluating cisplatin-based first-line chemotherapy in patients with metastatic urothelial carcinoma. Adverse events, treatment delivery, response proportions, and survival outcomes were compared between patients aged<70 vs.≥70 years. Results: Of the 543 patients included, 162 patients (30%) were≥70 years old. The majority (93%) of elderly patients were aged 70 to 79 years. There was no significant difference in the proportions of patients experiencing Grade 3 to 4 renal failure, febrile neutropenia, or treatment-related death between younger and older patient cohorts. The median survival of the patients≥70 years was 12.1 months compared to 12.8 months for patients<70 years (P = 0.91). There was no significant difference in survival between age groups when controlling for baseline performance status or the presence of visceral metastases or both. Conclusions: Fit septuagenarians, with adequate renal function, tolerate cisplatin-based chemotherapy similarly to their younger counterparts and achieve comparable clinical outcomes. © 2014 Elsevier Inc.
Συγγραφείς:
Galsky, M.D.
Krege, S.
Lin, C.-C.
Hahn, N.
Ecke, T.H.
Moshier, E.
Sonpavde, G.
Godbold, J.
Oh, W.K.
Bamias, A.
Περιοδικό:
Urologic Oncology: Seminars and Original Investigations
Εκδότης:
HANLEY & BELFUS-ELSEVIER INC
Λέξεις-κλειδιά:
bevacizumab; cisplatin; docetaxel; doxorubicin; fluorouracil; gemcitabine; methotrexate; paclitaxel; sorafenib; sunitinib; vinblastine; antineoplastic agent; cisplatin, adult; aged; antineoplastic activity; article; blood toxicity; cancer combination chemotherapy; cancer patient; cancer survival; drug efficacy; drug fatality; drug safety; drug tolerability; elderly care; febrile neutropenia; female; groups by age; human; kidney failure; major clinical study; male; middle aged; multiple cycle treatment; neutropenia; phase 2 clinical trial (topic); phase 3 clinical trial (topic); priority journal; sepsis; survival time; thrombocytopenia; thromboembolism; transitional cell carcinoma; treatment outcome; treatment response; very elderly; visceral metastasis; cohort analysis; Kaplan Meier method; meta analysis; metastasis; pathology; survival analysis; Urologic Neoplasms; urothelium, Adult; Aged; Aged, 80 and over; Antineoplastic Agents; Antineoplastic Combined Chemotherapy Protocols; Cisplatin; Clinical Trials, Phase II as Topic; Clinical Trials, Phase III as Topic; Cohort Studies; Female; Humans; Kaplan-Meier Estimate; Male; Middle Aged; Neoplasm Metastasis; Survival Analysis; Treatment Outcome; Urologic Neoplasms; Urothelium
DOI:
10.1016/j.urolonc.2012.11.001
