Obesity and outcomes in patients with metastatic urothelial carcinoma

Amanda Leiter, John Doucette, Susan Krege, Chia Chi Lin, Noah Hahn, Thorsten Ecke, Guru Sonpavde, Aristotle Bamias, William K. Oh, Matthew D. Galsky

Research output: Contribution to journalArticle

Abstract

Background: Obesity has been associated with worse outcomes in patients with clinically localized urothelial cancer. However, this impact has not been evaluated in metastatic disease. Objective: To assess the impact of obesity on outcomes of patients with metastatic urothelial cancer. Methods: Data from 537 patients were aggregated from eight phase II and phase III clinical trials investigating firstline cisplatin-based combination therapy in metastatic urothelial cancer. Chemotherapy regimen, adverse events, treatment response, and survival outcomes were compared across body mass index (BMI) and body surface area (BSA) categories. Results:BMIwas classified according toWHOcriteria (<18.5 underweight, 18.5-24.99 normal weight, 25-29.99 overweight, >30 obese). BSA was classified as either below or greater than or equal to (average for this cohort (1.87m2 for males and 1.66m2 for females). There was no significant difference in number of chemotherapy cycles, adverse events, and response rate or survival outcomes (overall and progression-free) across BMI and BSA categories. There was no significant difference in adverse events across BMI categories, but the incidences of embolic events and renal failure were higher in patients with an average or higher BSA than those with a lower than average BSA (6.6% vs. 3.1% for renal failure p = 0.06; 5.9% vs. 2.7% for renal failure, p = 0.07). There was no significant difference in response rate or survival outcomes (overall and progression-free) amongst BMI and BSA categories. Conclusions: Obese patients with metastatic urothelial cancer on cisplatin-based therapies have similar response rates, survival outcomes, and tolerability of cisplatin-based therapy to non-obese patients.

Original languageEnglish (US)
Pages (from-to)341-349
Number of pages9
JournalBladder Cancer
Volume2
Issue number3
DOIs
StatePublished - Jan 1 2016

Fingerprint

Body Surface Area
Obesity
Carcinoma
Body Mass Index
Cisplatin
Renal Insufficiency
Survival Rate
Neoplasms
Drug Therapy
Phase III Clinical Trials
Therapeutics
Survival
Incidence

Keywords

  • BMI
  • Body mass index
  • Body surface area
  • BSA
  • Metastatic bladder cancer
  • Metastatic urothelial cancer
  • Obesity

ASJC Scopus subject areas

  • Oncology
  • Urology

Cite this

Leiter, A., Doucette, J., Krege, S., Lin, C. C., Hahn, N., Ecke, T., ... Galsky, M. D. (2016). Obesity and outcomes in patients with metastatic urothelial carcinoma. Bladder Cancer, 2(3), 341-349. https://doi.org/10.3233/BLC-160047

Obesity and outcomes in patients with metastatic urothelial carcinoma. / Leiter, Amanda; Doucette, John; Krege, Susan; Lin, Chia Chi; Hahn, Noah; Ecke, Thorsten; Sonpavde, Guru; Bamias, Aristotle; Oh, William K.; Galsky, Matthew D.

In: Bladder Cancer, Vol. 2, No. 3, 01.01.2016, p. 341-349.

Research output: Contribution to journalArticle

Leiter, A, Doucette, J, Krege, S, Lin, CC, Hahn, N, Ecke, T, Sonpavde, G, Bamias, A, Oh, WK & Galsky, MD 2016, 'Obesity and outcomes in patients with metastatic urothelial carcinoma', Bladder Cancer, vol. 2, no. 3, pp. 341-349. https://doi.org/10.3233/BLC-160047
Leiter, Amanda ; Doucette, John ; Krege, Susan ; Lin, Chia Chi ; Hahn, Noah ; Ecke, Thorsten ; Sonpavde, Guru ; Bamias, Aristotle ; Oh, William K. ; Galsky, Matthew D. / Obesity and outcomes in patients with metastatic urothelial carcinoma. In: Bladder Cancer. 2016 ; Vol. 2, No. 3. pp. 341-349.
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AU - Doucette, John

AU - Krege, Susan

AU - Lin, Chia Chi

AU - Hahn, Noah

AU - Ecke, Thorsten

AU - Sonpavde, Guru

AU - Bamias, Aristotle

AU - Oh, William K.

AU - Galsky, Matthew D.

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AB - Background: Obesity has been associated with worse outcomes in patients with clinically localized urothelial cancer. However, this impact has not been evaluated in metastatic disease. Objective: To assess the impact of obesity on outcomes of patients with metastatic urothelial cancer. Methods: Data from 537 patients were aggregated from eight phase II and phase III clinical trials investigating firstline cisplatin-based combination therapy in metastatic urothelial cancer. Chemotherapy regimen, adverse events, treatment response, and survival outcomes were compared across body mass index (BMI) and body surface area (BSA) categories. Results:BMIwas classified according toWHOcriteria (<18.5 underweight, 18.5-24.99 normal weight, 25-29.99 overweight, >30 obese). BSA was classified as either below or greater than or equal to (average for this cohort (1.87m2 for males and 1.66m2 for females). There was no significant difference in number of chemotherapy cycles, adverse events, and response rate or survival outcomes (overall and progression-free) across BMI and BSA categories. There was no significant difference in adverse events across BMI categories, but the incidences of embolic events and renal failure were higher in patients with an average or higher BSA than those with a lower than average BSA (6.6% vs. 3.1% for renal failure p = 0.06; 5.9% vs. 2.7% for renal failure, p = 0.07). There was no significant difference in response rate or survival outcomes (overall and progression-free) amongst BMI and BSA categories. Conclusions: Obese patients with metastatic urothelial cancer on cisplatin-based therapies have similar response rates, survival outcomes, and tolerability of cisplatin-based therapy to non-obese patients.

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