Cisplatin-based combination chemotherapy in septuagenarians with metastatic urothelial cancer

Matthew D. Galsky, Susan Krege, Chia Chi Lin, Noah Hahn, Thorsten H. Ecke, Erin Moshier, Guru Sonpavde, James Godbold, William K. Oh, Aristotle Bamias

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: Cisplatin-based chemotherapy is standard first-line treatment for metastatic urothelial carcinoma. However, cisplatin is frequently avoided in elderly patients due to concerns regarding toxicities. We analyzed the efficacy, and tolerability, of cisplatin-based chemotherapy in elderly patients. Methods: Individual patient data were pooled from 8 phase II and III trials evaluating cisplatin-based first-line chemotherapy in patients with metastatic urothelial carcinoma. Adverse events, treatment delivery, response proportions, and survival outcomes were compared between patients aged<70 vs.≥70 years. Results: Of the 543 patients included, 162 patients (30%) were≥70 years old. The majority (93%) of elderly patients were aged 70 to 79 years. There was no significant difference in the proportions of patients experiencing Grade 3 to 4 renal failure, febrile neutropenia, or treatment-related death between younger and older patient cohorts. The median survival of the patients≥70 years was 12.1 months compared to 12.8 months for patients<70 years (P = 0.91). There was no significant difference in survival between age groups when controlling for baseline performance status or the presence of visceral metastases or both. Conclusions: Fit septuagenarians, with adequate renal function, tolerate cisplatin-based chemotherapy similarly to their younger counterparts and achieve comparable clinical outcomes.

Original languageEnglish (US)
Pages (from-to)30.e15-30.e21
JournalUrologic Oncology: Seminars and Original Investigations
Volume32
Issue number1
DOIs
StatePublished - Jan 2014
Externally publishedYes

Keywords

  • Bladder neoplasm
  • Cisplatin
  • Elderly
  • Metastatic
  • Urothelial neoplasm

ASJC Scopus subject areas

  • Oncology
  • Urology

Fingerprint Dive into the research topics of 'Cisplatin-based combination chemotherapy in septuagenarians with metastatic urothelial cancer'. Together they form a unique fingerprint.

Cite this