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Comparative Study of the Safety and Efficacy of First-Line Cisplatin and Carboplatin Chemotherapy in Elderly Patients with Metastatic Urothelial Carcinoma.
Oncology 2019; :1-8O

Abstract

OBJECTIVES

Platinum-based chemotherapy is the standard treatment for metastatic urothelial carcinoma (mUC). However, considering elderly patients often experience comorbidities and frailty, the utility of cisplatin-based chemotherapy for elderly patients is still debatable. We conducted this study to compare the safety and efficacy of carboplatin and cisplatin in elderly patients with mUC.

METHODS

This retrospective study enrolled elderly patients with mUC (defined as aged ≥70 years) who underwent first-line platinum-based chemotherapy between September 2001 and October 2018. The primary endpoints were chemotherapy-related adverse events (AEs), including treatment-related hospitalization or death. The secondary outcomes were overall survival (OS) and progression-free survival calculated by Kaplan-Meier analysis.

RESULTS

In total, 108 elderly patients with mUC were enrolled and allocated into the cisplatin or carboplatin group. Patients treated with carboplatin-based chemotherapy had a significantly higher incidence of all grade ≥3 AEs (78.8 vs. 50.0%, p = 0.008) than those on cisplatin. AE-related hospitalization (47.5 vs. 19.1%, p = 0.002) and treatment-related death (17.5 vs. 4.4%, p = 0.02) were significantly increased in the carboplatin group. In the univariate analysis, the median OS in the cisplatin group was significantly increased compared with the carboplatin group (13.6 vs. 7.2 months, p = 0.045). The Cox multivariate regression model indicated that leukocytosis (HR 3.17, 95% CI 1.84-5.46, p < 0.001) and anemia (HR 2.02, 95% CI 1.11-3.65, p = 0.02) were independent prognostic factors.

CONCLUSION

Elderly patients with mUC treated with cisplatin-based chemotherapy had better survival and safety profiles than those treated with carboplatin. Age itself was not a crucial factor in determining cisplatin eligibility.

Authors+Show Affiliations

Division of Hematology-Oncology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung City, Taiwan.Division of Hematology-Oncology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung City, Taiwan.Department of Hematology Oncology, E-Da Cancer Hospital and I-Shou University, Taiwan, Kaohsiung City, Taiwan.Department of Hematology Oncology, E-Da Cancer Hospital and I-Shou University, Taiwan, Kaohsiung City, Taiwan.Department of Urology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung City, Taiwan.Department of Pathology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung City, Taiwan.Department of Urology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung City, Taiwan.Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung City, Taiwan.Division of Hematology-Oncology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung City, Taiwan.Division of Urology, Department of Surgery, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan City, Taiwan.Division of Hematology-Oncology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung City, Taiwan, yolisu@mac.com. Clinical Trial Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung City, Taiwan, yolisu@mac.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31794969

Citation

Huang, Shih-Yu, et al. "Comparative Study of the Safety and Efficacy of First-Line Cisplatin and Carboplatin Chemotherapy in Elderly Patients With Metastatic Urothelial Carcinoma." Oncology, 2019, pp. 1-8.
Huang SY, Wu CC, Hsieh MC, et al. Comparative Study of the Safety and Efficacy of First-Line Cisplatin and Carboplatin Chemotherapy in Elderly Patients with Metastatic Urothelial Carcinoma. Oncology. 2019.
Huang, S. Y., Wu, C. C., Hsieh, M. C., Rau, K. M., Chiang, P. H., Sung, M. T., ... Su, H. Y. (2019). Comparative Study of the Safety and Efficacy of First-Line Cisplatin and Carboplatin Chemotherapy in Elderly Patients with Metastatic Urothelial Carcinoma. Oncology, pp. 1-8. doi:10.1159/000504393.
Huang SY, et al. Comparative Study of the Safety and Efficacy of First-Line Cisplatin and Carboplatin Chemotherapy in Elderly Patients With Metastatic Urothelial Carcinoma. Oncology. 2019 Dec 3;1-8. PubMed PMID: 31794969.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparative Study of the Safety and Efficacy of First-Line Cisplatin and Carboplatin Chemotherapy in Elderly Patients with Metastatic Urothelial Carcinoma. AU - Huang,Shih-Yu, AU - Wu,Chia-Che, AU - Hsieh,Meng-Che, AU - Rau,Kun-Ming, AU - Chiang,Po-Hui, AU - Sung,Ming-Tse, AU - Luo,Hao-Lun, AU - Huang,Chun-Chieh, AU - Huang,Cheng-Hua, AU - Liu,Jui-Ming, AU - Su,Harvey Yu-Li, Y1 - 2019/12/03/ PY - 2019/10/18/received PY - 2019/10/23/accepted PY - 2019/12/4/entrez PY - 2019/12/4/pubmed PY - 2019/12/4/medline KW - Adverse event KW - Elderly KW - Metastatic urothelial carcinoma KW - Overall survival KW - Platinum-based chemotherapy SP - 1 EP - 8 JF - Oncology JO - Oncology N2 - OBJECTIVES: Platinum-based chemotherapy is the standard treatment for metastatic urothelial carcinoma (mUC). However, considering elderly patients often experience comorbidities and frailty, the utility of cisplatin-based chemotherapy for elderly patients is still debatable. We conducted this study to compare the safety and efficacy of carboplatin and cisplatin in elderly patients with mUC. METHODS: This retrospective study enrolled elderly patients with mUC (defined as aged ≥70 years) who underwent first-line platinum-based chemotherapy between September 2001 and October 2018. The primary endpoints were chemotherapy-related adverse events (AEs), including treatment-related hospitalization or death. The secondary outcomes were overall survival (OS) and progression-free survival calculated by Kaplan-Meier analysis. RESULTS: In total, 108 elderly patients with mUC were enrolled and allocated into the cisplatin or carboplatin group. Patients treated with carboplatin-based chemotherapy had a significantly higher incidence of all grade ≥3 AEs (78.8 vs. 50.0%, p = 0.008) than those on cisplatin. AE-related hospitalization (47.5 vs. 19.1%, p = 0.002) and treatment-related death (17.5 vs. 4.4%, p = 0.02) were significantly increased in the carboplatin group. In the univariate analysis, the median OS in the cisplatin group was significantly increased compared with the carboplatin group (13.6 vs. 7.2 months, p = 0.045). The Cox multivariate regression model indicated that leukocytosis (HR 3.17, 95% CI 1.84-5.46, p < 0.001) and anemia (HR 2.02, 95% CI 1.11-3.65, p = 0.02) were independent prognostic factors. CONCLUSION: Elderly patients with mUC treated with cisplatin-based chemotherapy had better survival and safety profiles than those treated with carboplatin. Age itself was not a crucial factor in determining cisplatin eligibility. SN - 1423-0232 UR - https://www.unboundmedicine.com/medline/citation/31794969/Comparative_Study_of_the_Safety_and_Efficacy_of_First-Line_Cisplatin_and_Carboplatin_Chemotherapy_in_Elderly_Patients_with_Metastatic_Urothelial_Carcinoma L2 - https://www.karger.com?DOI=10.1159/000504393 DB - PRIME DP - Unbound Medicine ER -