Multicenter evaluation of neoadjuvant and induction gemcitabine-carboplatin versus gemcitabine-cisplatin followed by radical cystectomy for muscle-invasive bladder cancer.
Bladder
Carboplatin
Chemotherapy
Cisplatin
Neoadjuvant
Radical cystectomy
Urothelial cancer
Journal
World journal of urology
ISSN: 1433-8726
Titre abrégé: World J Urol
Pays: Germany
ID NLM: 8307716
Informations de publication
Date de publication:
Nov 2022
Nov 2022
Historique:
received:
04
07
2022
accepted:
17
09
2022
pubmed:
29
9
2022
medline:
2
11
2022
entrez:
28
9
2022
Statut:
ppublish
Résumé
Cisplatin-based chemotherapy followed by radical cystectomy (RC) is recommended in patients with muscle-invasive bladder cancer (MIBC). However, up to 50% of patients are cisplatin ineligible. The aim of this study was to compare clinical outcomes after ≥ 3 cycles of preoperative gemcitabine-carboplatin (gem-carbo) versus gemcitabine-cisplatin (gem-cis). We identified 1865 patients treated at 19 centers between 2000 and 2013. Patients were included if they had received ≥ 3 cycles of neoadjuvant (cT2-4aN0M0) or induction (cTanyN + M0) gem-carbo or gem-cis followed by RC. We included 747 patients treated with gem-carbo (n = 147) or gem-cis (n = 600). Patients treated with gem-carbo had a higher Charlson Comorbidity Index (p = 0.016) and more clinically node-positive disease (32% versus 20%; p = 0.013). The complete pathological response (pCR; ypT0N0) rate did not significantly differ between gem-carbo and gem-cis (20.7% versus 22.1%; p = 0.73). Chemotherapeutic regimen was not significantly associated with pCR (OR 0.99 [95%CI 0.61-1.59]; p = 0.96), overall survival (OS) (HR 1.20 [95%CI 0.85-1.67]; p = 0.31), or cancer-specific survival (CSS) (HR 1.35 [95%CI 0.93-1.96]; p = 0.11). Median OS of patients treated with gem-carbo and gem-cis was 28.6 months (95%CI 18.1-39.1) and 45.1 months (95%CI 32.7-57.6) (p = 0.18), respectively. Median CSS of patients treated with gem-carbo and gem-cis was 28.8 months (95%CI 9.8-47.8) and 71.0 months (95%CI median not reached) (p = 0.02), respectively. Subanalyses of the neoadjuvant and induction setting did not show significant survival differences. Our results show that a subset of cisplatin-ineligible patients with MIBC achieve pCR on gem-carbo and that survival outcomes seem comparable to gem-cis provided patients are able to receive ≥ 3 cycles and undergo RC.
Identifiants
pubmed: 36169695
doi: 10.1007/s00345-022-04160-7
pii: 10.1007/s00345-022-04160-7
doi:
Substances chimiques
Cisplatin
Q20Q21Q62J
Carboplatin
BG3F62OND5
Gemcitabine
0
Types de publication
Multicenter Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2707-2715Informations de copyright
© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
Références
Witjes JA, Bruins HM, Cathomas R, Compérat EM, Cowan NC, Gakis G, et al. European Association of Urology Guidelines on Muscle-invasive and Metastatic Bladder Cancer: Summary of the 2020 Guidelines. Eur Urol 2020:1–23. https://doi.org/10.1016/j.eururo.2020.03.055 .
Advanced Bladder Cancer Meta-analysis Collaboration (2005) Neoadjuvant chemotherapy for invasive bladder cancer. Eur Urol 13:136–146. https://doi.org/10.1007/s11934-012-0236-2
doi: 10.1007/s11934-012-0236-2
Mertens LS, Meijer RP, Meinhardt W, Van Der Poel HG, Bex A, Kerst JM et al (2014) Occult lymph node metastases in patients with carcinoma invading bladder muscle: Incidence after neoadjuvant chemotherapy and cystectomy vs after cystectomy alone. BJU Int 114:67–74. https://doi.org/10.1111/bju.12447
doi: 10.1111/bju.12447
pubmed: 24053889
Galsky MD, Hahn NM, Rosenberg J, Sonpavde G, Hutson T, Oh WK et al (2011) A consensus definition of patients with metastatic urothelial carcinoma who are unfit for cisplatin-based chemotherapy. Lancet Oncol 12:211–214. https://doi.org/10.1016/S1470-2045(10)70275-8
doi: 10.1016/S1470-2045(10)70275-8
pubmed: 21376284
Bellmunt J, Ribas A, Eres N, Albanell J, Almanza C, Bermejo B et al (1997) Carboplatin-based versus cisplatin-based chemotherapy in the treatment of surgically incurable advanced bladder carcinoma. Cancer 80:1966–1972. https://doi.org/10.1002/(SICI)1097-0142(19971115)80:10%3c1966::AID-CNCR14%3e3.0.CO;2-W
doi: 10.1002/(SICI)1097-0142(19971115)80:10<1966::AID-CNCR14>3.0.CO;2-W
pubmed: 9366300
De Santis M, Bellmunt J, Mead G, Kerst JM, Leahy M, Maroto P et al (2009) Randomized Phase II/III Trial Assessing Gemcitabine/ Carboplatin and Methotrexate/Carboplatin/Vinblastine in Patients With Advanced Urothelial Cancer “Unfit” for Cisplatin-Based Chemotherapy: Phase II—Results of EORTC Study 30986. J Clin Oncol 27:5634–5639. https://doi.org/10.1200/JCO.2008.21.4924
doi: 10.1200/JCO.2008.21.4924
pubmed: 19786668
pmcid: 2792956
von der Maase H, Sengelov L, Roberts JT, Ricci S, Dogliotti L, Oliver T et al (2005) Long-Term Survival Results of a Randomized Trial Comparing Gemcitabine Plus Cisplatin, With Methotrexate, Vinblastine, Doxorubicin, Plus Cisplatin in Patients With Bladder Cancer. J Clin Oncol 23:4602–4608. https://doi.org/10.1200/JCO.2005.07.757
doi: 10.1200/JCO.2005.07.757
pubmed: 16034041
Powles T, van der Heijden MS, Castellano D, Galsky MD, Loriot Y, Petrylak DP et al (2020) Durvalumab alone and durvalumab plus tremelimumab versus chemotherapy in previously untreated patients with unresectable, locally advanced or metastatic urothelial carcinoma (DANUBE): a randomised, open-label, multicentre, phase 3 trial. Lancet Oncol 21:1574–1588. https://doi.org/10.1016/S1470-2045(20)30541-6
doi: 10.1016/S1470-2045(20)30541-6
pubmed: 32971005
Richters A, Boormans JL, van der Heijden MS, van der Heijden AG, Meijer RP, Mehra N et al (2021) Overall Survival of Patients Receiving Cisplatin or Carboplatin for Primary Metastatic Urothelial Carcinoma of the Bladder: A Contemporary Dutch Nationwide Cohort Study. Eur Urol Focus. https://doi.org/10.1016/j.euf.2021.08.009
doi: 10.1016/j.euf.2021.08.009
pubmed: 34535437
Zargar H, Espiritu PN, Fairey AS, Mertens LS, Dinney CP, Mir MC et al (2015) Multicenter Assessment of Neoadjuvant Chemotherapy for Muscle-invasive Bladder Cancer. Eur Urol 67:241–249. https://doi.org/10.1016/j.eururo.2014.09.007
doi: 10.1016/j.eururo.2014.09.007
pubmed: 25257030
Zargar-Shoshtari K, Zargar H, Lotan Y, Shah JB, Van Rhijn BW, Daneshmand S et al (2016) A Multi-Institutional Analysis of Outcomes of Patients with Clinically Node Positive Urothelial Bladder Cancer Treated with Induction Chemotherapy and Radical Cystectomy. J Urol 195:53–59. https://doi.org/10.1016/j.juro.2015.07.085
doi: 10.1016/j.juro.2015.07.085
pubmed: 26205531
Mertens LS, Meijer RP, Kerst JM, Bergman AM, Van Tinteren H, Van Rhijn BWG et al (2012) Carboplatin based induction chemotherapy for nonorgan confined bladder cancer - A reasonable alternative for cisplatin unfit patients? J Urol 188:1108–1114. https://doi.org/10.1016/j.juro.2012.06.018
doi: 10.1016/j.juro.2012.06.018
pubmed: 22901581
Murasawa H, Koie T, Ohyama C, Yamamoto H, Imai A, Hatakeyama S et al (2017) The utility of neoadjuvant gemcitabine plus carboplatin followed by immediate radical cystectomy in patients with muscle-invasive bladder cancer who are ineligible for cisplatin-based chemotherapy. Int J Clin Oncol 22:159–165. https://doi.org/10.1007/s10147-016-1029-2
doi: 10.1007/s10147-016-1029-2
pubmed: 27534866
Peyton CC, Tang D, Reich RR, Azizi M, Chipollini J, Pow-Sang JM et al (2018) Downstaging and Survival Outcomes Associated with Neoadjuvant Chemotherapy Regimens among Patients Treated with Cystectomy for Muscle-Invasive Bladder Cancer. JAMA Oncol 4:1535–1542. https://doi.org/10.1001/jamaoncol.2018.3542
doi: 10.1001/jamaoncol.2018.3542
pubmed: 30178038
pmcid: 6248089
Koie T, Ohyama C, Hashimoto Y, Hatakeyama S, Yamamoto H, Yoneyama T et al (2013) Efficacies and safety of neoadjuvant gemcitabine plus carboplatin followed by immediate cystectomy in patients with muscle-invasive bladder cancer, including those unfit for cisplatin: A prospective single-arm study. Int J Clin Oncol 18:724–730. https://doi.org/10.1007/s10147-012-0447-z
doi: 10.1007/s10147-012-0447-z
pubmed: 23011100
Koie T, Ohyama C, Yamamoto H, Imai A, Hatakeyama S, Yoneyama T et al (2014) Neoadjuvant gemcitabine and carboplatin followed by immediate cystectomy may be associated with a survival benefit in patients with clinical T2 bladder cancer. Med Oncol 31:949. https://doi.org/10.1007/s12032-014-0949-9
doi: 10.1007/s12032-014-0949-9
pubmed: 24700028
pmcid: 4006118
Hermans TJN, Voskuilen CS, van der Heijden MS, Schmitz-Dräger BJ, Kassouf W, Seiler R et al (2018) Neoadjuvant treatment for muscle-invasive bladder cancer: The past, the present, and the future. Urol Oncol Semin Orig Investig 36:413–422. https://doi.org/10.1016/j.urolonc.2017.10.014
doi: 10.1016/j.urolonc.2017.10.014
Galsky MD, Chen GJ, Oh WK, Bellmunt J, Roth BJ, Petrioli R et al (2012) Comparative effectiveness of cisplatin-based and carboplatin-based chemotherapy for treatment of advanced urothelial carcinoma. Ann Oncol 23:406–410. https://doi.org/10.1093/annonc/mdr156
doi: 10.1093/annonc/mdr156
pubmed: 21543626
Richters A, Kiemeney LALM, Mehra N, Westgeest HM, Birtle A, Bryan RT, et al. Evidence or Prejudice? Critical Re-Analysis of Randomized Controlled Trials Comparing Overall Survival After Cisplatin Versus Carboplatin-Based Regimens in Advanced Urothelial Carcinoma. Clin Genitourin Cancer 2021:1–7. https://doi.org/10.1016/j.clgc.2021.12.017 .
Martini A, Raggi D, Fallara G, Nocera L, Schultz JG, Belladelli F et al (2022) Immunotherapy versus chemotherapy as first-line treatment for advanced urothelial cancer: A systematic review and meta-analysis. Cancer Treat Rev 104:102360. https://doi.org/10.1016/j.ctrv.2022.102360
doi: 10.1016/j.ctrv.2022.102360
pubmed: 35176685