To investigate the impact of renal impairment (RI) on the efficacy of first-line chemotherapy in patients with locally advanced or metastatic upper tract urothelial carcinoma (la/mUTUC).
This multicenter retrospective study evaluated 300 patients with la/mUTUC who received GEM/CDDP or GEM/CBDCA as first-line chemotherapy. RI was defined as eGFR < 45 mL/min/1.73 m2 and used to categorize patients into RI and without-RI groups. Objective response rate (ORR), progression-free survival (PFS), and overall survival (OS) were analyzed. Multivariable Cox proportional hazard analysis was conducted to assess risk factors for PFS and OS. In the RI group, oncologic outcomes were compared between GEM/CDDP and GEM/CBDCA.
Overall, 130 patients (43%) had RI, and 170 (57%) did not. During a median follow-up of 32 months, 188 patients (63%) died: 74 patients (56%) in the RI group and 114 (67%) in the without-RI group. Among 288 evaluable patients, the ORR was 34% in the RI group and 45% in the without-RI group (p = 0.072). The median PFS of the RI and without-RI groups was 5.6 and 4.8 months, respectively (p = 0.322), and the median OS was 16.9 and 14.5 months, respectively (p = 0.074). Among the RI group, no significant differences were observed between GEM/CDDP and GEM/CBDCA in PFS (6.4 vs. 4.2 months, p = 0.113) or OS (21.4 vs. 15.2 months, p = 0.142).
In la/mUTUC, oncologic outcomes were comparable between patients with and without RI. In the RI group, responses to GEM/CDDP and GEM/CBDCA did not differ.
International journal of urology : official journal of the Japanese Urological Association. 2025 Jun 04 [Epub ahead of print]
Tomoki Kimura, Motohiro Fujiwara, Yuya Maezawa, Kensaku Ishihara, Naoki Inoue, Kenji Tanabe, Keita Izumi, Masahiro Toide, Takanobu Yamamoto, Sho Uehara, Saori Araki, Masaharu Inoue, Ryoji Takazawa, Noboru Numao, Yukihiro Ohtsuka, Yuma Waseda, Hajime Tanaka, Soichiro Yoshida, Yasuhisa Fujii
Department of Urology, Institute of Science Tokyo, Tokyo, Japan., Department of Urology, Tsuchiura Kyodo General Hospital, Ibaraki, Japan., Department of Urology, Soka Municipal Hospital, Saitama, Japan., Department of Urology, JA Toride Medical Hospital, Ibaraki, Japan., Department of Urology, Saitama Red Cross Hospital, Saitama, Japan., Department of Urology, Dokkyo Medical University Saitama Medical Center, Saitama, Japan., Department of Urology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan., Department of Urology, Tokyo Metropolitan Tama-Nambu Chiiki Hospital, Tokyo, Japan., Department of Urology, Showa General Hospital, Tokyo, Japan., Department of Urology, Kohnodai Hospital, Chiba, Japan., Department of Urology, Saitama Cancer Center, Saitama, Japan., Department of Urology, Tokyo Metropolitan Ohtsuka Hospital, Tokyo, Japan., Department of Urology, Cancer Institute Hospital, Tokyo, Japan., Department of Urology, Japanese Red Cross Omori Hospital, Tokyo, Japan.