PMID- 26618338 OWN - NLM STAT- MEDLINE DCOM- 20160707 LR - 20221207 IS - 1097-0142 (Electronic) IS - 0008-543X (Print) IS - 0008-543X (Linking) VI - 122 IP - 5 DP - 2016 Mar 1 TI - The high incidence of vascular thromboembolic events in patients with metastatic or unresectable urothelial cancer treated with platinum chemotherapy agents. PG - 712-21 LID - 10.1002/cncr.29801 [doi] AB - BACKGROUND: The current study compared the incidence of vascular thromboembolic events (VTEs) in patients with metastatic or unresectable urothelial carcinoma (UC) who were treated with gemcitabine and carboplatin (GCb); gemcitabine, carboplatin, and bevacizumab (GCbBev); or gemcitabine and cisplatin (GCis). METHODS: Patients with UC who were treated with GCbBev on protocol were analyzed prospectively and 2 contemporary control cohorts receiving GCb or GCis were evaluated retrospectively. VTE was defined as either venous or arterial (myocardial infarctions or cerebral vascular accidents) thrombosis. VTEs were considered to be related to treatment if they occurred during treatment or within 4 weeks of the completion of treatment. Associations with chemotherapy regimen were tested using either the Fisher exact test or Kruskal-Wallis test. Clinical factors associated with VTEs were analyzed using conditional logistic regression stratified by treatment regimen. RESULTS: Among 198 patients, VTEs occurred in 13 of 51 patients treated with GCbBev (26%), 22 of 92 patients treated with GCb (24%), and 8 of 55 patients treated with GCis (15%). Patient characteristics were significantly different between the treatment cohorts in terms of age, prior cystectomy, tumor location near pelvic vessels, Khorana risk group, and receipt of antiplatelet therapy. The incidence of VTE and type of VTE (arterial vs venous) did not differ by type of chemotherapy. Prior cystectomy was associated with an increased risk of VTE (odds ratio, 2.2; 95% confidence interval, 1.0-4.9 [P = .047]). CONCLUSIONS: The incidence of VTE in Cis-treated patients was similar to prior reports. However, the VTE rate in Cb-treated patients was > 20%, a figure not previously defined in patients with UC and higher than expected. This high incidence of both Cis-related and Cb-related VTEs warrants greater awareness by treating physicians and deserves further study. Cancer 2016;122:712-721. (c) 2015 American Cancer Society. CI - (c) 2015 American Cancer Society. FAU - Tully, Christopher M AU - Tully CM AD - Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York. AD - Department of Medicine, Weill Medical College of Cornell University, New York, New York. FAU - Apolo, Andrea B AU - Apolo AB AD - Genitourinary Malignancies Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland. FAU - Zabor, Emily C AU - Zabor EC AD - Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York. FAU - Regazzi, Ashley M AU - Regazzi AM AD - Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York. FAU - Ostrovnaya, Irina AU - Ostrovnaya I AD - Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York. FAU - Furberg, Helena F AU - Furberg HF AD - Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York. FAU - Rosenberg, Jonathan E AU - Rosenberg JE AD - Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York. AD - Department of Medicine, Weill Medical College of Cornell University, New York, New York. FAU - Bajorin, Dean F AU - Bajorin DF AD - Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York. AD - Department of Medicine, Weill Medical College of Cornell University, New York, New York. LA - eng GR - P30 CA008748/CA/NCI NIH HHS/United States PT - Clinical Study PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't DEP - 20151130 PL - United States TA - Cancer JT - Cancer JID - 0374236 RN - 0W860991D6 (Deoxycytidine) RN - 2S9ZZM9Q9V (Bevacizumab) RN - BG3F62OND5 (Carboplatin) RN - Q20Q21Q62J (Cisplatin) RN - 0 (Gemcitabine) SB - IM MH - Aged MH - Antineoplastic Combined Chemotherapy Protocols/*therapeutic use MH - Bevacizumab/administration & dosage MH - Carboplatin/administration & dosage MH - Carcinoma, Transitional Cell/*drug therapy/pathology/secondary MH - Case-Control Studies MH - Cisplatin/administration & dosage MH - Deoxycytidine/administration & dosage/analogs & derivatives MH - Female MH - Humans MH - Incidence MH - Kidney Neoplasms/drug therapy/pathology MH - Kidney Pelvis/pathology MH - Logistic Models MH - Male MH - Middle Aged MH - Myocardial Infarction/*epidemiology MH - Prospective Studies MH - Retrospective Studies MH - Stroke/*epidemiology MH - Ureteral Neoplasms/drug therapy/pathology MH - Urinary Bladder Neoplasms/drug therapy/pathology MH - Urologic Neoplasms/*drug therapy/pathology MH - Venous Thromboembolism/*epidemiology MH - Gemcitabine PMC - PMC4990408 MID - NIHMS792309 OTO - NOTNLM OT - bladder cancer OT - carboplatin OT - cisplatin OT - thrombosis OT - urothelial carcinoma EDAT- 2015/12/01 06:00 MHDA- 2016/07/09 06:00 PMCR- 2017/03/01 CRDT- 2015/12/01 06:00 PHST- 2015/07/01 00:00 [received] PHST- 2015/10/03 00:00 [revised] PHST- 2015/10/22 00:00 [accepted] PHST- 2017/03/01 00:00 [pmc-release] PHST- 2015/12/01 06:00 [entrez] PHST- 2015/12/01 06:00 [pubmed] PHST- 2016/07/09 06:00 [medline] AID - 10.1002/cncr.29801 [doi] PST - ppublish SO - Cancer. 2016 Mar 1;122(5):712-21. doi: 10.1002/cncr.29801. Epub 2015 Nov 30.