PMID- 31794969
OWN - NLM
STAT- MEDLINE
DCOM- 20200309
LR  - 20200309
IS  - 1423-0232 (Electronic)
IS  - 0030-2414 (Linking)
VI  - 98
IP  - 3
DP  - 2020
TI  - Comparative Study of the Safety and Efficacy of First-Line Cisplatin and 
      Carboplatin Chemotherapy in Elderly Patients with Metastatic Urothelial 
      Carcinoma.
PG  - 146-153
LID - 10.1159/000504393 [doi]
AB  - OBJECTIVES: Platinum-based chemotherapy is the standard treatment for metastatic 
      urothelial carcinoma (mUC). However, considering elderly patients often 
      experience comorbidities and frailty, the utility of cisplatin-based chemotherapy 
      for elderly patients is still debatable. We conducted this study to compare the 
      safety and efficacy of carboplatin and cisplatin in elderly patients with mUC. 
      METHODS: This retrospective study enrolled elderly patients with mUC (defined as 
      aged >/=70 years) who underwent first-line platinum-based chemotherapy between 
      September 2001 and October 2018. The primary endpoints were chemotherapy-related 
      adverse events (AEs), including treatment-related hospitalization or death. The 
      secondary outcomes were overall survival (OS) and progression-free survival 
      calculated by Kaplan-Meier analysis. RESULTS: In total, 108 elderly patients with 
      mUC were enrolled and allocated into the cisplatin or carboplatin group. Patients 
      treated with carboplatin-based chemotherapy had a significantly higher incidence 
      of all grade >/=3 AEs (78.8 vs. 50.0%, p = 0.008) than those on cisplatin. 
      AE-related hospitalization (47.5 vs. 19.1%, p = 0.002) and treatment-related 
      death (17.5 vs. 4.4%, p = 0.02) were significantly increased in the carboplatin 
      group. In the univariate analysis, the median OS in the cisplatin group was 
      significantly increased compared with the carboplatin group (13.6 vs. 7.2 months, 
      p = 0.045). The Cox multivariate regression model indicated that leukocytosis (HR 
      3.17, 95% CI 1.84-5.46, p < 0.001) and anemia (HR 2.02, 95% CI 1.11-3.65, p = 
      0.02) were independent prognostic factors. CONCLUSION: Elderly patients with mUC 
      treated with cisplatin-based chemotherapy had better survival and safety profiles 
      than those treated with carboplatin. Age itself was not a crucial factor in 
      determining cisplatin eligibility.
CI  - (c) 2019 S. Karger AG, Basel.
FAU - Huang, Shih-Yu
AU  - Huang SY
AD  - Division of Hematology-Oncology, Department of Internal Medicine, Kaohsiung Chang 
      Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 
      City, Taiwan.
FAU - Wu, Chia-Che
AU  - Wu CC
AD  - Division of Hematology-Oncology, Department of Internal Medicine, Kaohsiung Chang 
      Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 
      City, Taiwan.
FAU - Hsieh, Meng-Che
AU  - Hsieh MC
AD  - Department of Hematology Oncology, E-Da Cancer Hospital and I-Shou University, 
      Taiwan, Kaohsiung City, Taiwan.
FAU - Rau, Kun-Ming
AU  - Rau KM
AD  - Department of Hematology Oncology, E-Da Cancer Hospital and I-Shou University, 
      Taiwan, Kaohsiung City, Taiwan.
FAU - Chiang, Po-Hui
AU  - Chiang PH
AD  - Department of Urology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung 
      University College of Medicine, Kaohsiung City, Taiwan.
FAU - Sung, Ming-Tse
AU  - Sung MT
AD  - Department of Pathology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung 
      University College of Medicine, Kaohsiung City, Taiwan.
FAU - Luo, Hao-Lun
AU  - Luo HL
AD  - Department of Urology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung 
      University College of Medicine, Kaohsiung City, Taiwan.
FAU - Huang, Chun-Chieh
AU  - Huang CC
AD  - Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital and 
      Chang Gung University College of Medicine, Kaohsiung City, Taiwan.
FAU - Huang, Cheng-Hua
AU  - Huang CH
AD  - Division of Hematology-Oncology, Department of Internal Medicine, Kaohsiung Chang 
      Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 
      City, Taiwan.
FAU - Liu, Jui-Ming
AU  - Liu JM
AD  - Division of Urology, Department of Surgery, Taoyuan General Hospital, Ministry of 
      Health and Welfare, Taoyuan City, Taiwan.
FAU - Su, Harvey Yu-Li
AU  - Su HY
AD  - Division of Hematology-Oncology, Department of Internal Medicine, Kaohsiung Chang 
      Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 
      City, Taiwan, yolisu@mac.com.
AD  - Clinical Trial Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung City, 
      Taiwan, yolisu@mac.com.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20191203
PL  - Switzerland
TA  - Oncology
JT  - Oncology
JID - 0135054
RN  - BG3F62OND5 (Carboplatin)
RN  - Q20Q21Q62J (Cisplatin)
SB  - IM
MH  - Age Factors
MH  - Aged
MH  - Aged, 80 and over
MH  - Antineoplastic Combined Chemotherapy Protocols/adverse effects/*therapeutic use
MH  - Carboplatin/*administration & dosage/adverse effects
MH  - Carcinoma/*drug therapy/mortality/secondary
MH  - Cisplatin/*administration & dosage/adverse effects
MH  - Disease Progression
MH  - Female
MH  - Humans
MH  - Male
MH  - Progression-Free Survival
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Risk Factors
MH  - Time Factors
MH  - Urologic Neoplasms/*drug therapy/mortality/pathology
MH  - Urothelium/*drug effects/pathology
OTO - NOTNLM
OT  - Adverse event
OT  - Elderly
OT  - Metastatic urothelial carcinoma
OT  - Overall survival
OT  - Platinum-based chemotherapy
EDAT- 2019/12/04 06:00
MHDA- 2020/03/10 06:00
CRDT- 2019/12/04 06:00
PHST- 2019/10/18 00:00 [received]
PHST- 2019/10/23 00:00 [accepted]
PHST- 2019/12/04 06:00 [pubmed]
PHST- 2020/03/10 06:00 [medline]
PHST- 2019/12/04 06:00 [entrez]
AID - 000504393 [pii]
AID - 10.1159/000504393 [doi]
PST - ppublish
SO  - Oncology. 2020;98(3):146-153. doi: 10.1159/000504393. Epub 2019 Dec 3.