A retrospective study on optimal number of cycles of the first-line platinum-based chemotherapy for metastatic urothelial carcinoma
| Autor: | Minoru Kato, Katsuyuki Kuratsukuri, Shoma Yamamoto, Yukiyoshi Hirayama, Junji Uchida, Takeshi Yamasaki, Yuji Takeyama, Nao Yukimatsu, Taiyo Otoshi |
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| Rok vydání: | 2021 |
| Předmět: |
Oncology
Adult Male medicine.medical_specialty Metastatic Urothelial Carcinoma Urology medicine.medical_treatment Carboplatin Avelumab chemistry.chemical_compound Internal medicine Antineoplastic Combined Chemotherapy Protocols Medicine Humans Aged Platinum Retrospective Studies Cisplatin Aged 80 and over Chemotherapy Carcinoma Transitional Cell business.industry Retrospective cohort study Middle Aged medicine.disease Gemcitabine chemistry Urinary Bladder Neoplasms Female business Progressive disease medicine.drug |
| Zdroj: | Urologic oncology. 40(5) |
| ISSN: | 1873-2496 |
| Popis: | Background Recently, switch maintenance with avelumab has been approved for the treatment of advanced or metastatic urothelial carcinoma (UC), with no progression after four to six cycles of first-line platinum-based chemotherapy. However, the optimal number of cycles of platinum-based chemotherapy has not been determined. Objective To analyze the clinical characteristics of patients with advanced UC who were treated with platinum-based chemotherapy and investigate the association between the number of cycles of the treatment and the patients’ overall survival. Methods A total of 124 patients with advanced UC who were treated with first-line platinum-based chemotherapy at Osaka City University Hospital between April 2009 and January 2020 were retrospectively reviewed. Results Of the 124 patients, clinical information regarding overall survival was available for 115 patients. The median age was 72 years (range, 43–95 years). Only 59 patients (51.3 %) were treated with gemcitabine and cisplatin, and 52 patients (45.2 %) were treated with gemcitabine and carboplatin. The median number of cycles was three (1–8), and the percentage of patients who discontinued chemotherapy due to progressive disease was 80.3%, 64.0%, and 86.4% in those receiving one to three, four, and five or more cycles, respectively. Moreover, no difference in overall survival was observed between patients who received four cycles and those who received five or more cycles at both univariate and multivariate levels. Conclusions The present study shows that five or more cycles of first-line platinum-based chemotherapy did not prolong overall survival compared with four cycles, suggesting that four cycles of chemotherapy might be sufficient, considering the new treatment strategy involving switch maintenance with avelumab. |
| Databáze: | OpenAIRE |
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