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

Research output: Contribution to journalArticlepeer-review

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

ASJC Scopus subject areas

  • Medicine(all)

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