Treatment Patterns and Outcomes in Stage IV Bladder Cancer in a Community Oncology Setting: 2008-2015
| Autor: | Maxine D. Fisher, Mark S. Walker, Rahul Shenolikar, Moon Fenton, Paul J. E. Miller |
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| Rok vydání: | 2018 |
| Předmět: |
Male
Oncology medicine.medical_specialty Urology Population Cystectomy Disease-Free Survival 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Internal medicine Antineoplastic Combined Chemotherapy Protocols Outcome Assessment Health Care medicine Humans Community Health Services 030212 general & internal medicine Progression-free survival Practice Patterns Physicians' education Aged Neoplasm Staging Retrospective Studies Aged 80 and over Prostatectomy education.field_of_study Bladder cancer Proportional hazards model business.industry Hazard ratio Middle Aged medicine.disease United States Gemcitabine Carboplatin Regimen Urinary Bladder Neoplasms chemistry Chemotherapy Adjuvant 030220 oncology & carcinogenesis Female business medicine.drug |
| Zdroj: | Clinical Genitourinary Cancer. 16:e1171-e1179 |
| ISSN: | 1558-7673 |
| DOI: | 10.1016/j.clgc.2018.07.025 |
| Popis: | Current real-world data regarding treatment patterns in advanced bladder cancer in the community setting are limited. This study describes patient characteristics, treatment patterns, and effectiveness outcomes for stage IV bladder cancer in the community setting.Medical records data of adults diagnosed with stage IV bladder cancer between January 1, 2008 and June 1, 2015 were retrospectively collected from a network of United States community oncology practices. Patient characteristics, treatment patterns, and efficacy outcomes were assessed. Across-group comparisons were conducted using bivariate analyses. Kaplan-Meier and Cox regression analyses of progression-free survival and overall survival (OS) were conducted.Of 508 patients (mean age, 70 ± 11 years), 75.2% were male, 79.1% white, 15.4% black, and 71.5% were ≥ 65 years. The most prevalent comorbidities were diabetes (23.4%) and renal disease (16.5%). Overall, 56% of patients received first-line platinum-based chemotherapy; the most common regimen was gemcitabine/carboplatin (23.6%), followed by gemcitabine/cisplatin (17%). The median OS was 9.4 months from stage IV bladder cancer diagnosis and 8.4 months from start of first-line therapy. Cox regression analysis of OS from diagnosis showed a higher risk of death for patients with no treatment (hazard ratio [HR], 2.06; P .0001) or other treatment (HR, 1.83; P = .002) versus cisplatin and for patients with impaired performance (HR, 2.05; P .0001).Platinum-based chemotherapy was the most prescribed treatment for stage IV bladder cancer in the community setting. Several patients were not treated with any chemotherapy, although we did not observe the reason for no treatment. This study highlights an unmet need in this population, particularly in a relapsed/refractory setting, and the need for improvement in outcomes. |
| Databáze: | OpenAIRE |
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