Chemotherapy for Muscle-invasive Bladder Cancer: Impact of Cisplatin Delivery on Renal Function and Local Control Rate in the Randomized Phase III VESPER (GETUG-AFU V05) Trial

Autor: Sophie Abadie-Lacourtoisie, Thierry Nguyen-Tan-Hon, Jean-Philippe Spano, Olivier Huillard, Nadine Houede, Hakim Mahammedi, Eric Voog, Yohann Loriot, Tifenn Lharidon, Sheik Emambux, Stéphane Culine, Lionnel Geoffrois, Jean-Christophe Eymard, Mounira El Demery, V. Harter, Vesper Trial Investigators, Philippe Barthélémy, Brigitte Laguerre, Yves Allory, Christine Chevreau, Aline Guillot, Florence Joly, Frédéric Di Fiore, Carolina Saldana, Gwenaelle Gravis, Christian Pfister, Werner Hilgers, Camille Serrate, Guilhem Roubaud, Sabine Vieillot, Aude Fléchon, Frederic Rolland
Přispěvatelé: Hopital Saint-Louis [AP-HP] (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN), Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC), Département cancer environnement (Centre Léon Bérard - Lyon), Centre Léon Bérard [Lyon], Institut Universitaire du Cancer de Toulouse - Oncopole (IUCT Oncopole - UMR 1037), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Jean Perrin [Clermont-Ferrand] (UNICANCER/CJP), UNICANCER, Département d'oncologie médicale [Rennes], CRLCC Eugène Marquis (CRLCC), Institut de Cancérologie de la Loire Lucien Neuwirth, Centre Hospitalier Universitaire de Saint-Etienne (CHU de Saint-Etienne), Institut de Cancérologie de l'Ouest [Angers/Nantes] (UNICANCER/ICO), Institut de Cancérologie de Lorraine - Alexis Vautrin [Nancy] (UNICANCER/ICL), Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), Hôpital Charles Nicolle [Rouen], Institut Bergonié [Bordeaux], CHU Strasbourg, Clinique Victor Hugo [Le Mans], Centre hospitalier universitaire de Poitiers (CHU Poitiers), Groupe Hospitalier Diaconesses Croix Saint-Simon, CHU Henri Mondor, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Biomarqueurs prédictifs et nouvelles stratégies moléculaires en thérapeutique anticancéreuse (U981), Université Paris-Sud - Paris 11 (UP11)-Institut Gustave Roussy (IGR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Jean Godinot [Reims], Sorbonne Université (SU), Hôpital Cochin [AP-HP], Institut de Recherche en Cancérologie de Montpellier (IRCM - U1194 Inserm - UM), CRLCC Val d'Aurelle - Paul Lamarque-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Service d'Oncologie médicale [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre Hospitalier Départemental - Hôpital de La Roche-sur-Yon (CHD Vendée), Institut Sainte Catherine [Avignon], Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Centre d'Investigation Clinique [CHU Rouen] (CIC Rouen), Hôpital Charles Nicolle [Rouen]-CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Rok vydání: 2021
Předmět:
MESH: Muscles
medicine.medical_treatment
Pathological downstaging
Kidney
[SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology
Antineoplastic Combined Chemotherapy Protocols
Medicine
Muscles
Combination chemotherapy
Neoadjuvant Therapy
Cisplatin-based chemotherapy
MESH: Urinary Bladder Neoplasms
Vinblastine
MESH: Antineoplastic Combined Chemotherapy Protocols
MESH: Methotrexate
Oncology
MESH: Chemotherapy
Adjuvant
Chemotherapy
Adjuvant
medicine.drug
Neoadjuvant treatment
medicine.medical_specialty
Urology
MESH: Neoadjuvant Therapy
MESH: Vinblastine
[SDV.CAN]Life Sciences [q-bio]/Cancer
Cystectomy
MESH: Doxorubicin
Humans
Retrospective Studies
Cisplatin
Chemotherapy
Pathological complete response
Perioperative chemotherapy
MESH: Humans
Bladder cancer
business.industry
MESH: Cystectomy
MESH: Retrospective Studies
MESH: Kidney
medicine.disease
Gemcitabine
Methotrexate
MESH: Cisplatin
Urinary Bladder Neoplasms
Doxorubicin
business
Zdroj: Clinical Genitourinary Cancer
Clinical Genitourinary Cancer, 2021, 19 (6), pp.554-562. ⟨10.1016/j.clgc.2021.08.005⟩
ISSN: 1558-7673
Popis: Background : Cisplatin-based combination chemotherapy before surgery is the standard of care for muscle-invasive bladder cancer. However, the optimal chemotherapy modalities have not been precisely defined to date. Patients and Methods : In the VESPER trial, patients received after randomization either gemcitabine and cisplatin (GC, 4 cycles) or methotrexate, vinblastine, doxorubicin and cisplatin (dose dense [dd]-MVAC, 6 cycles). Creatinine clearance (CrCl) was calculated before each cycle according to the Cockroft and Gault formula. Definition criteria for local control after neoadjuvant chemotherapy included pathological complete response (ypT0N0), pathological downstaging ( Results : A total of 2,128 cycles of chemotherapy were delivered, including 2,120 (99.6%) with cisplatin. Full doses of cisplatin were given in 1866 (88%) cycles. Twenty-three (4.7%) patients had to stop chemotherapy (12 GC, 11 dd-MVAC) because of renal failure. No difference in CrCl median values was observed between the two regimens during the first four cycles. A mild decrease occurred thereafter in patients treated with two additional cycles of dd-MVAC. A minimum total dose of 270 mg/m2 for cisplatin was mandatory to optimize pathological complete responses. Conclusion : At least 4 cycles of cisplatin-based chemotherapy should be delivered before cystectomy. Increasing the number of cycles beyond 4 cycles does not lead to a clinically significant deterioration in renal function but without obvious gain on local control. MicroAbstractCGC : A deep analysis of data from a randomized trial of perioperative chemotherapy in muscle-invasive bladder cancer shows that a minimum number of 4 cycles is required to optimize the chances of pathological complete response at cystectomy. Increasing the number beyond 4 cycles does not lead to a clinically significant deterioration in renal function without any obvious gain on pathological complete response.
Databáze: OpenAIRE
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