Comparison of Cisplatin versus Carboplatin Chemotherapy for Metastatic Urothelial Carcinoma in Patients with Stage 3 Chronic Kidney Disease

Date 24 November 2018
Event ESMO Asia 2018 Congress
Session Poster display - Cocktail
Topics Cancer Treatment in Patients with Comorbidities
Presenter Chia-Che Wu
Citation Annals of Oncology (2018) 29 (suppl_9): ix74-ix78. 10.1093/annonc/mdy435
Authors C. Wu, K. Rau, M. Hsieh, Y. Su
  • Hematology Oncology, Chang Gung Memorial Hospital-Kaohsiung, 833 - Kaohsiung/TW

Abstract

Background

Previous studies showed cisplatin-based chemotherapy has superior efficacy than carboplatin-based regimen in metastatic urothelial carcinoma (mUC) patients with normal renal function. In consideration of cisplatin related nephrotoxicity, there is no evidence about comparing the efficacy of cisplatin versus carboplatin among patients with stage 3 chronic kidney disease (CKD). This study aimed to investigate the change of renal function and survival outcome in stage 3 CKD patients treated with different platinum-based chemotherapy.

Methods

A total of 137 mUC patients with stage 3 CKD who underwent platinum-based chemotherapy at Kaohsiung Chang Gung Memorial Hospital between 1997 and 2015 were included. The estimated glomerular filtration rate (eGFR) was calculated by Cockcroft-Gault equation. CKD stage 3 was defined as individuals with eGFR 30-59 ml/min/1.73m2. We calculated the interval change of renal function between pre-treatment and two months of platinum chemotherapy (ΔeGFR). The progression-free survival (PFS) and overall survival (OS) were determined by Kaplan-Meier analyses and Cox regression model.

Results

Ninety-nine of the 137 patients (72%) received cisplatin-based regimen. Patients in cisplatin group had a higher mean pre-treatment eGFR (40.73±6.38 ml/min/1.73m2) than those in carboplatin group (38.52±6.18ml/min/1.73m2, p < 0.001). The difference of median PFS between cisplatin and carboplatin treatment was insignificant (5.3 versus 4.0 months, p = 0.82). The median OS were 12.5 and 8.9 months in the cisplatin and carboplatin group, respectively (p = 0.263). After 2 months of platinum treatment, there was no significant difference in the mean ΔeGFR between 2 groups (cisplatin versus carboplatin; 0.8: 2.9 ml/min/1.73m2).

Conclusions

Our study showed that cisplatin has a marginal survival benefit without immediately detrimental nephrotoxicity compared with that of carboplatin in mUC patients with stage 3 CKD.

Editorial acknowledgement

Clinical trial identification

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.