Cisplatin- Versus Non-Cisplatin-based First-Line Chemotherapy for Advanced Urothelial Carcinoma Previously Treated With Perioperative Cisplatin.

Autor: Locke JA; University of British Columbia, Vancouver, BC, Canada., Pond GR; McMaster University, Hamilton, ON, Canada., Sonpavde G; UAB Comprehensive Cancer Center, Birmingham, AL., Necchi A; Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy., Giannatempo P; Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy., Paluri RK; UAB Comprehensive Cancer Center, Birmingham, AL., Niegisch G; Heinrich Heine University, Medical Faculty, Dusseldorf, Germany., Albers P; Heinrich Heine University, Medical Faculty, Dusseldorf, Germany., Buonerba C; University Federico II, Naples, Italy., Di Lorenzo G; University Federico II, Naples, Italy., Vaishampayan UN; Wayne State University Cancer Center, Detroit, MI., North SA; Cross Cancer Institute, Edmonton, AB, Canada., Agarwal N; Huntsman Cancer Institute, University of Utah, Salt Lake City, UT., Hussain SA; University of Liverpool, Liverpool, United Kingdom., Pal S; City of Hope Cancer Center, Duarte, CA., Eigl BJ; British Columbia Cancer Agency, Vancouver, BC, Canada. Electronic address: Bernie.Eigl@bccancer.bc.ca.
Jazyk: angličtina
Zdroj: Clinical genitourinary cancer [Clin Genitourin Cancer] 2016 Aug; Vol. 14 (4), pp. 331-40. Date of Electronic Publication: 2015 Oct 24.
DOI: 10.1016/j.clgc.2015.10.005
Abstrakt: Introduction: The optimal choice of first-line chemotherapy for patients with relapse of urothelial carcinoma (UC) after perioperative cisplatin-based chemotherapy (PCBC) is unclear. We investigated the outcomes with cisplatin rechallenge versus a non-cisplatin regimen in patients with recurrent metastatic UC after PCBC in a multicenter retrospective study.
Patients and Methods: Individual patient-level data were collected for patients who had received various first-line chemotherapy regimens for advanced UC after previous PCBC. Cox proportional hazards models were used to investigate the prognostic ability of the type of perioperative and first-line chemotherapy to independently affect overall survival (OS) and progression-free survival (PFS) after accounting for known prognostic factors.
Results: Data were available for 145 patients (12 centers). The mean age was 62 years; the Eastern Cooperative Oncology Group (ECOG) performance status (PS) was > 0 for 42.0% of the patients. Of the 145 patients, 63% had received cisplatin-based first-line chemotherapy. The median time from previous chemotherapy (TFPC) was 6.2 months (range, 1-154 months). The median OS was 22 months (95% confidence interval [CI], 18-27 months), and the median PFS was 6 months (95% CI, 5-7 months). A better ECOG PS and a longer TFPC (> 12 months vs. ≤ 12 months; hazard ratio [HR], 0.32; 95% CI, 0.20-0.52; P < .001) was prognostic for OS and PFS. Cisplatin-based chemotherapy was associated with poor OS (HR, 1.86; 95% CI, 1.13-3.06; P = .015), which appeared to be pronounced in those patients with a TFPC of ≤ 12 months. Retreatment with cisplatin in the first-line setting was associated with worse OS (HR, 3.38; P < .001).
Conclusion: The results of the present retrospective analysis suggest that for patients who have undergone previous PCBC for UC, rechallenging with cisplatin might confer a poorer OS, especially for those with progression within < 1 year.
(Copyright © 2015 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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