BACKGROUND:Renal dysfunction, poor performance status, and comorbidities may preclude frontline cisplatin-based chemotherapy in patients with advanced urothelial carcinoma (UC).
The frequency of cisplatin-based chemotherapy administration in patients with advanced UC in community-based cancer centers is unknown.
PATIENTS AND METHODS: A retrospective study was conducted to evaluate chemotherapy regimens administered to patients with the AJCC (American Joint Committee on Cancer) stage-4 UC who, from 2001 to 2010, presented to Texas Oncology Cancer Centers. Frontline chemotherapy was classified as cisplatin based, carboplatin based, nonplatinum based, and as no chemotherapy administered.
RESULTS: A total of 298 patients were eligible for analysis, of whom 197 (66.1%) were men. The median age was 70 years (range, 28-97 years), and the primary sites of disease were bladder (243 [81.5%]), renal pelvis (41 [13.8%]), and ureter (14 [4.7%]). Overall, the regimens administered were cisplatin based in 107 patients (35.9%), carboplatin based in 81 (27.2%), and nonplatinum based in 25 (8.4%); no chemotherapy was administered in 71 (23.8%), and data were not available in 14 patients (4.7%). Cisplatin administration was more common in patients aged ≤ 70 years (62/150 [41.3%]) as opposed to >70 years (45/148 [30.4%]) (P = .05). Noncisplatin regimens or no chemotherapy were trending to be more commonly administered to patients >70 years (64.2 vs. 54.7%; P = .10). Limitations of a retrospective database study apply.
CONCLUSION: A first-line cisplatin-based regimen was administered to 35.9% of patients who presented with AJCC stage 4 UC in a community-based cancer center network. Drug development focused on tolerable single-agent therapy or combination regimens without a cisplatin backbone should be a priority.
Written by:
Sonpavde G, Watson D, Tourtellott M, Cowey CL, Hellerstedt B, Hutson TE, Zhan F, Vogelzang NJ. Are you the author?
Texas Oncology, Houston, TX; US Oncology Research, Houston, TX.
Reference: Clin Genitourin Cancer. 2012 Mar;10(1):1-5.
doi: 10.1016/j.clgc.2011.11.005
PubMed Abstract
PMID: 22340630
