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Content Provider | World Health Organization (WHO)-Global Index Medicus |
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Author | Galsky, Matthew D. Krege, Susan Lin, Chia-Chi Hahn, Noah Ecke, Thorsten H. Moshier, Erin Sonpavde, Guru Godbold, James Oh, William K. Bamias, Aristotle |
Description | Author Affiliation: Galsky MD ( The Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY. Electronic address: matthew.galsky@mssm.edu.); Krege S ( Urologische Klinik, Alexianer Krefeld GmbH, Krefeld, Germany.); Lin CC ( Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan.); Hahn N ( Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN.); Ecke TH ( HELIOS Hospital, Bad Saarow, Germany.); Moshier E ( The Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY.); Sonpavde G ( US Oncology Research, LLC, McKesson Specialty Health, The Woodlands, TX); Godbold J ( The Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY.); Oh WK ( The Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY.); Bamias A ( 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. |
File Format | HTM / HTML |
ISSN | 10781439 |
Issue Number | 1 |
Volume Number | 32 |
e-ISSN | 18732496 |
Journal | Urologic Oncology: Seminars and Original Investigations |
Language | English |
Publisher | Elsevier |
Publisher Date | 2014-01-01 |
Publisher Place | United States |
Access Restriction | Subscribed |
Subject Keyword | Discipline Urology Discipline Oncology Antineoplastic Agents Administration & Dosage Antineoplastic Combined Chemotherapy Protocols Therapeutic Use Cisplatin Urologic Neoplasms Drug Therapy Urothelium Pathology Adult Aged Aged, 80 And Over Clinical Trials, Phase Ii As Topic Clinical Trials, Phase Iii As Topic Cohort Studies Female Humans Kaplan-meier Estimate Male Middle Aged Neoplasm Metastasis Survival Analysis Treatment Outcome Journal Article Meta-analysis |
Content Type | Text |
Resource Type | Article |
Subject Domain (in MeSH) | Tissues Eukaryota Neoplasms Inorganic Chemicals Chemical Actions and Uses Diagnosis Therapeutics Investigative Techniques Persons |
Subject | Oncology Urology |
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