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Oncologist. 2019 May;24(5):688-690. doi: 10.1634/theoncologist.2018-0561. Epub 2019 Feb 6.

Efficacy of Split Schedule Versus Conventional Schedule Neoadjuvant Cisplatin-Based Chemotherapy for Muscle-Invasive Bladder Cancer.

Author information

1
University of North Carolina Medical Center, Chapel Hill, North Carolina, USA.
2
University of Rochester Medical Center, Rochester, New York, USA.
3
Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA.
4
MD Anderson Cancer Center at Cooper, Camden, New Jersey, USA.
5
Langone Medical Center, New York University, New York City, New York, USA.
6
Florida Cancer Specialists and Research Institute, Sarasota, Florida, USA.
7
Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
8
Department of Urology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
9
Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania, USA ronac.mamtani@uphs.upenn.edu.

Abstract

Neoadjuvant cisplatin-based chemotherapy (NAC; 70 mg/m2) is standard of care for muscle-invasive bladder carcinoma (MIBC). Many patients (pts) cannot receive cisplatin because of renal impairment, and administration of cisplatin 35 mg/m2 on day 1 + 8 or 1 + 2 (i.e., split schedule) is a commonly used alternative. In this retrospective analysis, we compared complete (pT0) and partial (<pT2) pathologic response rates between split schedule (SS) and conventional schedule (CS) pts, after 1:1 matching on chemotherapy regimen, number of cycles, tumor histology, and clinical stage. Eighty matched pts were identified. pT0 rates were 17.5% (95% confidence interval [CI], 7%-33%) and 32.5% (95% CI, 19%-49%) in SS and CS cisplatin pts, respectively (p = .21), corresponding to an odds ratio for pT0 of 0.45 (95% CI, 0.16-1.31) with SS cisplatin. Split schedule cisplatin was associated with numerically but not statistically significant lower pathologic response rates relative to full dose.

KEYWORDS:

Cisplatin; Muscle‐invasive bladder cancer; Neoadjuvant chemotherapy; Nephrotoxicity

Conflict of interest statement

Disclosures of potential conflicts of interest may be found at the end of this article.

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