Third-Line chemotherapy for metastatic Urothelial Cancer: A retrospective observational study

Giuseppe Di Lorenzo, Carlo Buonerba, Teresa Bellelli, Concetta Romano, Vittorino Montanaro, Matteo Ferro, Alfonso Benincasa, Dario Ribera, Giuseppe Lucarelli, Ottavio De Cobelli, Guru Sonpavde, Sabino De Placido

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Abstract

The prognosis of locally advanced (T3/T4 or N1) and metastatic disease urothelial carcinoma is poor. In this retrospective study, we reviewed data about patients receiving third-line chemotherapy for metastatic disease, in view of the lack of data in this setting. We retrospectively analyzed medical records of patients with a pathologic diagnosis of urothelial carcinoma treated with systemic chemotherapy for metastatic disease at 4 participating Institutions between January, 2010, and January, 2015. Cox proportional hazards regression was used to evaluate the association of the chemotherapy agent used versus others with overall survival, adjusted for 5 externally validated prognostic factors in advanced urothelial carcinoma. Of 182 patients that received first-line chemotherapy/adjuvant chemotherapy as defined above, 116 patients (63.73%) received second-line salvage treatment. Fifty-Two patients were finally included in this analysis, whereas 9 were excluded due to missing data. Third-line chemotherapy was based on cyclophosphamide, platinum, vinflunine, taxanes, and gemcitabine in 16, 12, 11, 10, and 3 patients, respectively. Median PFS (progression-free survival) and OS (overall survival) of the population were 13 (10-17) and 31 (28-36) weeks. Single-Agent cyclophosphamide was associated with a PFS of 18 (13-22) and an OS of 38 (33-41) weeks, whereas platinum-based combinations were associated with a PFS of 5 weeks and an OS of 8 weeks. Multivariate analysis showed improved survival in patients treated with cyclophosphamide (hazard ratio (HR)1/40.42; 95% CI: 0.20-0.89; P1/40.025) and a worse survival in those treated with platinum-based regimens (HR: 4.37; 95% CI1/41.95-9.77; P

Original languageEnglish
Article numbere2297
JournalMedicine (United States)
Volume94
Issue number51
DOIs
Publication statusPublished - 2015

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Observational Studies
Retrospective Studies
Drug Therapy
Survival
Platinum
Neoplasms
Cyclophosphamide
Disease-Free Survival
gemcitabine
Carcinoma
Taxoids
Salvage Therapy
Adjuvant Chemotherapy
Medical Records
Multivariate Analysis
Population

ASJC Scopus subject areas

  • Medicine(all)

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Di Lorenzo, G., Buonerba, C., Bellelli, T., Romano, C., Montanaro, V., Ferro, M., ... De Placido, S. (2015). Third-Line chemotherapy for metastatic Urothelial Cancer: A retrospective observational study. Medicine (United States), 94(51), [e2297]. https://doi.org/10.1097/MD.0000000000002297

Third-Line chemotherapy for metastatic Urothelial Cancer : A retrospective observational study. / Di Lorenzo, Giuseppe; Buonerba, Carlo; Bellelli, Teresa; Romano, Concetta; Montanaro, Vittorino; Ferro, Matteo; Benincasa, Alfonso; Ribera, Dario; Lucarelli, Giuseppe; De Cobelli, Ottavio; Sonpavde, Guru; De Placido, Sabino.

In: Medicine (United States), Vol. 94, No. 51, e2297, 2015.

Research output: Contribution to journalArticle

Di Lorenzo, G, Buonerba, C, Bellelli, T, Romano, C, Montanaro, V, Ferro, M, Benincasa, A, Ribera, D, Lucarelli, G, De Cobelli, O, Sonpavde, G & De Placido, S 2015, 'Third-Line chemotherapy for metastatic Urothelial Cancer: A retrospective observational study', Medicine (United States), vol. 94, no. 51, e2297. https://doi.org/10.1097/MD.0000000000002297
Di Lorenzo, Giuseppe ; Buonerba, Carlo ; Bellelli, Teresa ; Romano, Concetta ; Montanaro, Vittorino ; Ferro, Matteo ; Benincasa, Alfonso ; Ribera, Dario ; Lucarelli, Giuseppe ; De Cobelli, Ottavio ; Sonpavde, Guru ; De Placido, Sabino. / Third-Line chemotherapy for metastatic Urothelial Cancer : A retrospective observational study. In: Medicine (United States). 2015 ; Vol. 94, No. 51.
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abstract = "The prognosis of locally advanced (T3/T4 or N1) and metastatic disease urothelial carcinoma is poor. In this retrospective study, we reviewed data about patients receiving third-line chemotherapy for metastatic disease, in view of the lack of data in this setting. We retrospectively analyzed medical records of patients with a pathologic diagnosis of urothelial carcinoma treated with systemic chemotherapy for metastatic disease at 4 participating Institutions between January, 2010, and January, 2015. Cox proportional hazards regression was used to evaluate the association of the chemotherapy agent used versus others with overall survival, adjusted for 5 externally validated prognostic factors in advanced urothelial carcinoma. Of 182 patients that received first-line chemotherapy/adjuvant chemotherapy as defined above, 116 patients (63.73{\%}) received second-line salvage treatment. Fifty-Two patients were finally included in this analysis, whereas 9 were excluded due to missing data. Third-line chemotherapy was based on cyclophosphamide, platinum, vinflunine, taxanes, and gemcitabine in 16, 12, 11, 10, and 3 patients, respectively. Median PFS (progression-free survival) and OS (overall survival) of the population were 13 (10-17) and 31 (28-36) weeks. Single-Agent cyclophosphamide was associated with a PFS of 18 (13-22) and an OS of 38 (33-41) weeks, whereas platinum-based combinations were associated with a PFS of 5 weeks and an OS of 8 weeks. Multivariate analysis showed improved survival in patients treated with cyclophosphamide (hazard ratio (HR)1/40.42; 95{\%} CI: 0.20-0.89; P1/40.025) and a worse survival in those treated with platinum-based regimens (HR: 4.37; 95{\%} CI1/41.95-9.77; P",
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AU - Di Lorenzo, Giuseppe

AU - Buonerba, Carlo

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AU - Montanaro, Vittorino

AU - Ferro, Matteo

AU - Benincasa, Alfonso

AU - Ribera, Dario

AU - Lucarelli, Giuseppe

AU - De Cobelli, Ottavio

AU - Sonpavde, Guru

AU - De Placido, Sabino

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AB - The prognosis of locally advanced (T3/T4 or N1) and metastatic disease urothelial carcinoma is poor. In this retrospective study, we reviewed data about patients receiving third-line chemotherapy for metastatic disease, in view of the lack of data in this setting. We retrospectively analyzed medical records of patients with a pathologic diagnosis of urothelial carcinoma treated with systemic chemotherapy for metastatic disease at 4 participating Institutions between January, 2010, and January, 2015. Cox proportional hazards regression was used to evaluate the association of the chemotherapy agent used versus others with overall survival, adjusted for 5 externally validated prognostic factors in advanced urothelial carcinoma. Of 182 patients that received first-line chemotherapy/adjuvant chemotherapy as defined above, 116 patients (63.73%) received second-line salvage treatment. Fifty-Two patients were finally included in this analysis, whereas 9 were excluded due to missing data. Third-line chemotherapy was based on cyclophosphamide, platinum, vinflunine, taxanes, and gemcitabine in 16, 12, 11, 10, and 3 patients, respectively. Median PFS (progression-free survival) and OS (overall survival) of the population were 13 (10-17) and 31 (28-36) weeks. Single-Agent cyclophosphamide was associated with a PFS of 18 (13-22) and an OS of 38 (33-41) weeks, whereas platinum-based combinations were associated with a PFS of 5 weeks and an OS of 8 weeks. Multivariate analysis showed improved survival in patients treated with cyclophosphamide (hazard ratio (HR)1/40.42; 95% CI: 0.20-0.89; P1/40.025) and a worse survival in those treated with platinum-based regimens (HR: 4.37; 95% CI1/41.95-9.77; P

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