Second-line systemic therapies for metastatic urothelial carcinoma: a population-based cohort analysis

Current oncology

E. S. Tsang¹  K. N. Chi²  C. Forbes³ 

[1] BC Cancer–Vancouver Centre;BC Cancer–Vancouver Island Centre;University of British Columbia

关键词: bladder cancer;    metastatic disease;    urothelial cancer;    second-line chemotherapy;    systemic therapy;   

DOI  :  10.3747/co.26.4070

学科分类：肿瘤学

来源: Multimed, Inc.

【 摘 要 】

IntroductionPatients with urothelial carcinoma (uc) have a poor prognosis after progression on first-line cisplatinbased chemotherapy. Real-world data about second-line cytotoxic therapies are limited. We sought to characterize patients with metastatic uc who receive more than 1 line of systemic therapy and to describe their treatments and outcomes. MethodsUsing BC Cancer’s pharmacy database, we identified patients with documented metastatic uc who had received more than 1 line of systemic therapy. A retrospective chart review was then performed to collect clinicopathologic, treatment, and outcomes data. ResultsThe 51 included patients, of whom 42 were men (82%), had a median age of 65 years (range: 38–81 years). Sites of metastasis included lymph nodes ( n= 30), bone ( n= 7), lung ( n= 9), and peritoneum ( n= 2). Second-line chemotherapy regimens included gemcitabine–cisplatin [gc ( n= 14)], paclitaxel ( n= 24), docetaxel ( n= 12), and an oral topoisomerase i inhibitor ( n= 1). Median time to progression (ttp) and overall survival (os) were 2.0 and 6.83 months respectively. Compared with patients who received a different agent, patients who had experienced a prior response to first-line gc and who were re-challenged with second-line gc had a better median ttp (11.0 months vs. 6.0 months,p= 0.02) and survived longer (4.0 months vs. 1.0 months,p= 0.02). No differences in os between non-gc regimens were evident. ConclusionsIn patients with metastatic uc, overall outcomes remain poor, but compared with patients receiving other agents, the subgroup of patients re-challenged with second-line gc demonstrated improved ttp. Conventional chemotherapy regimens provide only modest benefits in the second-line setting and have largely been replaced with immunotherapy.

【 授权许可】

Unknown