Outcome of metastatic urothelial carcinoma treated by systemic chemotherapy: Prognostic factors based on real-world clinical practice in Japan

Abe, Takashige; Junji, Ishizaki; Kojima, Hiroshi; Minami, Keita; Matsumoto, Ryuji; Harabayashi, Toru; Sazawa, Ataru; Mochizuki, Takashi; Chiba, Shuichi; Akino, Tomoshige; Murakumo, Masashi; Minamino, Naoto; Tsuchiya, Kunihiko; Maruyama, Satoru; Murai, Sachiyo; Shinohara, Nobuo

doi:10.1016/j.urolonc.2016.08.016

Cited by 20 publications

(30 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There are some reports regarding the prognosis of predictive factor. Favorable PS, female gender, hemoglobin level > 10 g/dl, and single organ metastasis were previously reported to be favorable prognostic factors among Japanese mUC patients treated with systemic chemotherapy (Abe et al, 2016). Moreover, the ECOG PS at presentation, CRP level and response to prior chemotherapy were reported as prognostic factors for mUC patients undergoing second-line chemotherapy (Matsumoto et al, 2018).…”

Section: Discussionmentioning

confidence: 96%

Skeletal Muscle Mass Reduction Velocity as a Simple Prognostic Indicator for Patients with Metastatic Urothelial Carcinoma Receiving Second-Line Chemotherapy

Nagai

Naiki

Iida

et al. 2019

Asian Pac J Cancer Prev

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 96%

Skeletal Muscle Mass Reduction Velocity as a Simple Prognostic Indicator for Patients with Metastatic Urothelial Carcinoma Receiving Second-Line Chemotherapy

Nagai

Naiki

Iida

et al. 2019

Asian Pac J Cancer Prev

View full text Add to dashboard Cite

“…Pembrolizumab is approved for second-line treatment of patients with advanced/metastatic UC in Japan [12]; however, there are no clear guidelines on choosing second-line therapy for these patients. In clinical practice, a variety of combination and single-agent therapies are prescribed [9,10,28]. One small study was conducted to evaluate second-line combinations of gemcitabine and taxanes in Japanese patients with metastatic UC that progressed after platinum-based chemotherapy (N = 78) [28].…”

Section: Discussionmentioning

confidence: 99%

“…The most commonly reported grade ≥ 3 hematologic AEs in the gemcitabine plus paclitaxel arm and the gemcitabine plus docetaxel arm were neutropenia (80.5% vs 59.5%), anemia (43.9% vs 10.8%), and thrombocytopenia (43.9% vs 29.7%). Although not recommended in international guidelines, some triplet regimens, including paclitaxel, ifosfamide, and nedaplatin [9,10] or paclitaxel, cisplatin, and gemcitabine [29], are also used as second-line treatment regimens in real-world studies of bladder cancer in Japan. Both triplet regimens have been associated with development of grade 3-4 neutropenia [29,30].…”

Section: Discussionmentioning

confidence: 99%

“…However, the gemcitabine plus cisplatin regimen is preferred because of a more favorable tolerability profile [8]. No recommendation has been made regarding second-line treatment or treatment of patients ineligible for platinum-based therapy, and a variety of combination and single-agent treatments are used in the management of UC in clinical practice in Japan [8][9][10].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Pembrolizumab versus chemotherapy in recurrent, advanced urothelial cancer in Japanese patients: a subgroup analysis of the phase 3 KEYNOTE-045 trial

et al. 2019

View full text Add to dashboard Cite

Background The open-label, randomized, active-controlled KEYNOTE-045 study (NCT02256436) showed that second-line pembrolizumab significantly improved overall survival (OS) of patients with advanced/metastatic urothelial cancer (UC) that progressed after first-line platinum-containing chemotherapy, compared with standard chemotherapy (paclitaxel, docetaxel, or vinflunine). Pembrolizumab is approved for patients with bladder cancer in Japan. Patients and methods Analysis was performed in the subgroup of Japanese patients enrolled in the KEYNOTE-045 study. Coprimary end points were OS and progression-free survival (PFS). Objective response rate (ORR) and safety were secondary end points. Results Fifty-two Japanese patients (pembrolizumab, n = 30; chemotherapy, n = 22) were followed up for a median of 26.1 months. Patients who received pembrolizumab compared with chemotherapy had a 19% lower risk for death (hazard ratio [HR] 0.81, 95% CI 0.44-1.50); after adjusting for baseline covariates, the HR for OS was 0.61 (95% CI 0.32-1.15). The 24-month OS rate was higher with pembrolizumab (26.9% vs 14.3%). PFS was 2.0 and 4.9 months for pembrolizumab and chemotherapy, respectively (HR 1.71, 95% CI 0.95-3.08). ORR was similar for pembrolizumab and chemotherapy (20.0% vs 18.2%); durability of response was higher with pembrolizumab: 67% and 33% of patients, respectively, maintained a response for > 12 months. Treatment-related adverse events, including grade 3-5 events, occurred less frequently with pembrolizumab. Conclusions Pembrolizumab provided durable antitumor activity in patients with locally advanced/metastatic UC that progressed after platinum-containing chemotherapy in the overall population and in the Japanese subgroup; safety profile was consistent with that previously observed for pembrolizumab.

show abstract

“…The use of metastasectomy for metastatic urothelial cancer is reported to be low in the literatureup to 9% in selected post-chemotherapy populations. 29 This likely reflects the limited insight into who might benefit from this and the paucity of quality literature in this setting. To our knowledge, we are the first to report an increasing use of metastasectomy over time, albeit modest.…”

Section: Discussionmentioning

confidence: 99%

Predictors of use and overall survival for patients undergoing metastasectomy for bladder cancer in a national cohort

et al. 2020

View full text Add to dashboard Cite

Objectives To determine the use of surgical resection of metastatic disease in a large national sample and its association with overall survival. Methods The National Cancer Database was queried for patients with metastatic bladder cancer (2004–2016). Overall survival was assessed using Kaplan–Meier and multivariable Cox analyses. The associations between covariates and use of metastasectomy were assessed with multivariable logistic regression. Results Of the 16 382 patients with metastatic bladder cancer included, 6.8% underwent metastasectomy. Its use increased over time (4.7% in 2004 to 6.6% in 2016; per year odds ratio 1.02, 95% confidence interval 1.00–1.04, P = 0.019). Median survival was 7.0 months for patients who received metastasectomy and 5.1 months for those who did not (hazard ratio 0.85, 95% confidence interval 0.79–0.91, P < 0.001). In subgroup analyses, metastasectomy predicted longer survival in patients with lung (hazard ratio 0.73, 95% confidence interval 0.61–0.88, P = 0.001) or brain metastases (hazard ratio 0.58, 95% confidence interval 0.35–0.96, P = 0.035) and in patients with variant histology (hazard ratio 0.80, 95% confidence interval 0.69–0.93, P = 0.003). Conclusions In a national sample, the use of metastasectomy for bladder cancer is low. Furthermore, metastasectomy is associated with longer survival overall and in multiple subgroups. However, these results should be validated in future studies.

show abstract

Outcome of metastatic urothelial carcinoma treated by systemic chemotherapy: Prognostic factors based on real-world clinical practice in Japan

Abstract: Female sex, more favorable PS at presentation, hemoglobin level>10g/dl, and single organ metastasis were favorable prognostic factors. In addition, metastasectomy was associated with long-term disease control.

Cited by 20 publications

References 34 publications

Skeletal Muscle Mass Reduction Velocity as a Simple Prognostic Indicator for Patients with Metastatic Urothelial Carcinoma Receiving Second-Line Chemotherapy

Skeletal Muscle Mass Reduction Velocity as a Simple Prognostic Indicator for Patients with Metastatic Urothelial Carcinoma Receiving Second-Line Chemotherapy

Pembrolizumab versus chemotherapy in recurrent, advanced urothelial cancer in Japanese patients: a subgroup analysis of the phase 3 KEYNOTE-045 trial

Predictors of use and overall survival for patients undergoing metastasectomy for bladder cancer in a national cohort

Contact Info

Product

Resources

About