866P - Impact of platinum agent [Cisplatin (Cis) or Carboplatin (Ca)] in first-line chemotherapy (CT) on overall survival in metastatic urothelial carcino...

Date 27 September 2014
Event ESMO 2014
Session Poster Display session
Topics Cytotoxic agents
Urothelial Cancers
Therapy
Biological therapy
Presenter Marie Auvray
Citation Annals of Oncology (2014) 25 (suppl_4): iv280-iv304. 10.1093/annonc/mdu337
Authors M. Auvray1, Y. Vano1, P. Combe1, R. Elaidi2, E. Auclin1, C. Takouchop2, J. Medioni1, F. Scotte1, S. Oudard1
  • 1Medical Oncology Service, European Georges Pompidou hospital, FR-75015 - Paris/FR
  • 2Oncology, Association pour la Recherche sur les Therapeutiques Innovantes en Cancerologie, Paris/FR

Abstract

Aim

A Cis-based CT has become a standard in first-line for mUC in fit pts, whereas a Ca-based CT is usually preferred in unfit pts. A significant advantage of Cis-based CT on objective response had previously been observed in a meta-analysis (Galsky, 2012), but survival endpoints could not be assessed.

Methods

Clinical, biological, radiological data and CT modalities of mUC pts who achieved a first-line CT were retrospectively collected. Objective response rates (ORR), progression-free survival (PFS) and overall survival (OS) were determined. Hazard Ratio and 95% confidence intervals were derived from univariate or multivariate model including Platinum agent, Bajorin prognostic groups, presence of a 2nd line CT and ORR.

Results

99 consecutive mUC pts treated from 2002 to 2014 at the Georges Pompidou Hospital were evaluated. Age: median = 67 years (range: 41-87, >75y = 25%), sex ratio = 4, ECOG-PS: 0-1 = 78%, creatinine clearance: median = 60ml/min [10-136], Bajorin prognostic factors: 0 = 42%, 1 = 55%, 2 = 3%, severe cardiovascular comorbidities = 19.6%. Median follow-up = 27.3months (13.4-56.4). Most frequent metastatic sites were: nodes = 71%, lung = 30%, bones = 27%, liver = 19%. Median number of CT cycles: Cis = 6 (3-7), Ca = 6 (1-12). In univariate Cox model, a Cis-based CT was significantly associated with a better OS: HR = 0.50 (0.26-0.97), median(Cis) = 14.4 months (10.0-21.2), median(Ca) = 10.2m (8.7–10.9). No difference was observed in PFS: HR = 0.95 (0.58-1.55), median(Cis) = 6.3m (5.1-7.7), median(Ca)= 5.3m (4.3-6.3), (Log-Rank test: p = 0.845). Upon multivariate analysis only Bajorin criteria [HR = 1.76 (1.02-3.02)] and the presence of a subsequent line of CT [HR = 0.38 (0.22-0.66)] were significantly correlated to OS, the benefit of Cis-based CT being not significant [HR = 0.78 (0.39–1.55)], possibly due to the low number of events in the Cis group (11 upon 24 pts).

Conclusions

Cis-based 1st-line CT was associated with better OS in mUC pts but this result was not confirmed in the multivariate model. Presence of a 2nd-line CT was the most influential factor on survival.

Disclosure

Y. Vano: honoraria : Pfizer, Novartis, GSK, Sanofi, Astellas, Sandoz, Teva; S. Oudard: Stéphane Oudard : Consultant or AdvisoryRole; Entity: Sanofi, Novartis, Roche, Bayer, Keocyt, Amgen, Relationship: Myself, compensation: Compensated, Honoraria, Entity: Sanofi, Novartis, Roche, Bayer, Keocyt, Amgen, Pfizer, Relationship: Myself;. All other authors have declared no conflicts of interest.