Implications for Efficacy and Safety of Total Dose and Dose-Intensity of Neoadjuvant Gemcitabine-Cisplatin in Muscle-Invasive Bladder Cancer: Three-Week Versus Four-Week Regimen.
Neoadjuvant chemotherapy
cisplatin
gemcitabine
muscle invasive bladder cancer
Journal
Bladder cancer (Amsterdam, Netherlands)
ISSN: 2352-3735
Titre abrégé: Bladder Cancer
Pays: Netherlands
ID NLM: 101668567
Informations de publication
Date de publication:
2022
2022
Historique:
received:
14
05
2021
accepted:
08
12
2021
medline:
11
3
2022
pubmed:
11
3
2022
entrez:
12
7
2024
Statut:
epublish
Résumé
Neoadjuvant cisplatin-based chemotherapy is standard care prior to radical cystectomy in patients with muscle-invasive bladder cancer (MIBC). To assess efficacy and safety of two commonly used neoadjuvant schedules with different total doses and dose-intensities of gemcitabine and cisplatin (GC). Data were collected retrospectively from all patients treated between 2010 and 2018 with neoadjuvant chemotherapy according to clinical routine at seven centres in Sweden and Denmark. Patients in Sweden received three cycles of a 4-week schedule (GC-4w: cisplatin 70 mg/m A total of 251 patients were treated with GC-4w and 455 with GC-3w. pT0N0 was significantly higher for patients treated with GC-3w compared to GC-4w, 46% versus 32% (adjusted odds ratio [aOR] 1.80; 95% confidence interval [CI] 1.16-2.80; A significantly higher complete response-rate was observed in the patient group treated with the more cisplatin-dose-intense 3-week schedule. The side-effect profile was in favor of the 4-week approach while relapse-free and overall survival were similar.
Sections du résumé
BACKGROUND
BACKGROUND
Neoadjuvant cisplatin-based chemotherapy is standard care prior to radical cystectomy in patients with muscle-invasive bladder cancer (MIBC).
OBJECTIVE
OBJECTIVE
To assess efficacy and safety of two commonly used neoadjuvant schedules with different total doses and dose-intensities of gemcitabine and cisplatin (GC).
METHODS
METHODS
Data were collected retrospectively from all patients treated between 2010 and 2018 with neoadjuvant chemotherapy according to clinical routine at seven centres in Sweden and Denmark. Patients in Sweden received three cycles of a 4-week schedule (GC-4w: cisplatin 70 mg/m
RESULTS
RESULTS
A total of 251 patients were treated with GC-4w and 455 with GC-3w. pT0N0 was significantly higher for patients treated with GC-3w compared to GC-4w, 46% versus 32% (adjusted odds ratio [aOR] 1.80; 95% confidence interval [CI] 1.16-2.80;
CONCLUSIONS
CONCLUSIONS
A significantly higher complete response-rate was observed in the patient group treated with the more cisplatin-dose-intense 3-week schedule. The side-effect profile was in favor of the 4-week approach while relapse-free and overall survival were similar.
Identifiants
pubmed: 38994523
doi: 10.3233/BLC-211556
pii: BLC211556
pmc: PMC11181847
doi:
Types de publication
Journal Article
Langues
eng
Pagination
71-80Informations de copyright
© 2022 – The authors. Published by IOS Press.
Déclaration de conflit d'intérêts
K Holmsten has received speaker honoraria from Roche AB, Janssen; L Høj Omland has no conflicts of interest to report; A B Als has no conflicts of interest to report; M Agerbæk has no conflicts of interest to report; L Hammer Dohn has no conflicts of interest to report; H Lindberg has no conflicts of interest to report; N V Jensen has no conflicts of interest to report; A Carus has no conflicts of interest to report; M Moe has no conflicts of interest to report; A Hosseini has no conflicts of interest to report; C Radkiewicz has no conflicts of interest to report; H Pappot has received research funding from MSD and Roche, has served on an advisory board for MSD and has received speaker honoraria from BMS; A Ullén has received speaker honoraria or served on an advisory board for Pierre Fabre, Roche, Pfizer, Merck, Astellas Janssen-Cilag and MSD.