Early cessation of chemotherapy impacts survival outcomes in muscle-invasive bladder cancer
Click Here to Manage Email Alerts
Key takeaways:
- Early cessation of chemotherapy impacted OS in muscle-invasive bladder cancer.
- Prioritize administering at least 3 cycles of cisplatin-based chemotherapy when feasible to improve outcomes.
CHICAGO — Early cessation of chemotherapy as a result of intolerance had significant implications on pathologic response, OS and RFS in patients with muscle-invasive bladder cancer, according to a poster presentation at ASCO Annual Meeting.
The retrospective single-center study included 195 patients diagnosed with muscle-invasive bladder cancer between 2004 and 2017. The primary objective of the study was to determine RFS and OS stratified by cycles of neoadjuvant cisplatin-based chemotherapy.
“Chemotherapy can be very difficult to tolerate. Typically, patients with muscle-invasive bladder cancer (MIBC) at Fox Chase are treated with 3 cycles of cisplatin-based chemotherapy,” said Anumita Chakraborty, MD, an internal medicine resident at Temple University Hospital. “This study was prompted from seeing that a significant number of patients with MIBC aren't able to complete the recommended 3 cycles. We wanted to see what the recurrence and survival outcomes were in this group of patients compared to patients who were able to complete at least 3 cycles of chemotherapy.”
Of the patients included, 30 (15.4%) received fewer than three cycles and 165 (84.6%) received three or more cycles of neoadjuvant cisplatin-based chemotherapy (NAC). For their treatment, 142 patients received methotrexate, vinblastine, doxorubicin and cisplatin, while 53 patients received gemcitabine and cisplatin.
Complete pathologic response was observed in 7.4% of patients who received fewer than three cycles and in 26.8% of patients who received three or more cycles (P = .024). Significant pathologic response occurred in 22.2% of patients receiving fewer than three cycles and in 41.8% of patients receiving three or more cycles (P > .05). Patients who received fewer than three cycles had a median RFS of 8.8 months (95% CI, 6.51-13.4) compared with 54.5 months (95% CI, 29.8-111.9) in those receiving three or more cycles.
“These findings suggest that clinicians should recommend completion of 3 cycles of chemotherapy whenever feasible and should monitor patients who are not able to complete 3 cycles very closely for recurrence,” said Chakraborty. “Importantly, this was a single-center study, more studies will have to be conducted on this patient population in other centers in order to determine generalizability of these results.”
Collapse
Chakraborty A, et al. Abstract 4586. Presented at: ASCO Annual Meeting; June 2-6, 2022; Chicago.
Read more about
Click Here to Manage Email Alerts