Epicure: A European epidemiological study of patients with an advanced or metastatic Urothelial Carcinoma (UC) having progressed to a platinum-based chemotherapy

N. Houédé, G. Locker, C. Lucas, H. Soto Parra, U. Basso, D. Spaeth, R. Tambaro, L. Basterretxea, F. Morelli, C. Theodore, L. Lusuardi, N. Lainez, A. Guillot, G. Tonini, J. Bielle, X. Garcia Del Muro

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Abstract

Background: Platinum-based systemic chemotherapy is considered the backbone for management of advanced urothelial carcinomas. However there is a lack of real world data on the use of such chemotherapy regimens, on patient profiles and on management after treatment failure. Methods: Fifty-one randomly selected physicians from 4 European countries registered 218 consecutive patients in progression or relapse following a first platinum-based chemotherapy. Patient characteristics, tumor history and treatment regimens, as well as the considerations of physicians on the management of urothelial carcinoma were recorded. Results: A systemic platinum-based regimen had been administered as the initial chemotherapy in 216 patients: 15 in the neoadjuvant setting, 61 in adjuvant therapy conditions, 137 in first-line advanced setting and 3 in other conditions. Of these patients, 76 (35 %) were initially considered as cisplatin-unfit, mainly because of renal impairment (52 patients). After platinum failure, renal impairment was observed in 44 % of patients, ECOG Performance Status ≥ 2 in 17 %, hemoglobinemia < 10 g/dL in 16 %, hepatic metastases in 13 %. 80 % of these patients received further anticancer therapy. Immediately after failure of adjuvant/neoadjuvant chemotherapy, most subsequent anticancer treatments were chemotherapy doublets (35/58), whereas after therapy failure in the advanced setting most patients receiving further anticancer drugs were treated with a single agent (80/114). After first progression to chemotherapy, treatment decisions were mainly driven by Performance Status and prior response to chemotherapy (>30 % patients). The most frequent all-settings second anticancer therapy regimen was vinflunine (70 % of single-agent and 42 % of all subsequent treatments), the main reasons evoked by physicians (>1 out of 4) being survival benefit, safety and phase III evidence. Conclusion: In this daily practice experience, a majority of patients with urothelial carcinoma previously treated with a platinum-based therapy received a second chemotherapy regimen, most often a single agent after an initial chemotherapy in the advanced setting and preferably a cytotoxic combination after a neoadjuvant or adjuvant chemotherapy. Performance Status and prior response to chemotherapy were the main drivers of further treatment decisions.

Original languageEnglish
Article number752
JournalBMC Cancer
Volume16
Issue number1
DOIs
Publication statusPublished - Sep 23 2016

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Keywords

  • Bladder cancer
  • Cisplatinum
  • Epidemiology
  • Metastatic
  • Practice
  • Second-line
  • Urothelial carcinoma
  • Vinflunine

ASJC Scopus subject areas

  • Oncology
  • Genetics
  • Cancer Research

Cite this

Houédé, N., Locker, G., Lucas, C., Parra, H. S., Basso, U., Spaeth, D., Tambaro, R., Basterretxea, L., Morelli, F., Theodore, C., Lusuardi, L., Lainez, N., Guillot, A., Tonini, G., Bielle, J., & Del Muro, X. G. (2016). Epicure: A European epidemiological study of patients with an advanced or metastatic Urothelial Carcinoma (UC) having progressed to a platinum-based chemotherapy. BMC Cancer, 16(1), [752]. https://doi.org/10.1186/s12885-016-2782-3