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Urol Oncol. 2014 Jan;32(1):30.e15-21. doi: 10.1016/j.urolonc.2012.11.001. Epub 2013 Feb 18.

Cisplatin-based combination chemotherapy in septuagenarians with metastatic urothelial cancer.

Author information

1
The Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY. Electronic address: matthew.galsky@mssm.edu.
2
Urologische Klinik, Alexianer Krefeld GmbH, Krefeld, Germany.
3
Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan.
4
Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN.
5
HELIOS Hospital, Bad Saarow, Germany.
6
The Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY.
7
US Oncology Research, LLC, McKesson Specialty Health, The Woodlands, TX; Texas Oncology, Webster, TX.
8
University of Athens & Hellenic Cooperative Oncology Group, Athens, Greece.

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.

KEYWORDS:

Bladder neoplasm; Cisplatin; Elderly; Metastatic; Urothelial neoplasm

PMID:
23428534
DOI:
10.1016/j.urolonc.2012.11.001
[Indexed for MEDLINE]

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