Determine cisplatin or carboplatin in first-line chemotherapy for elderly patients with metastatic urothelial carcinoma: Does age preclude cisplati...

Date 24 November 2018
Event ESMO Asia 2018 Congress
Session Poster display - Cocktail
Topics Geriatric Oncology
Presenter SHIH YU Huang
Citation Annals of Oncology (2018) 29 (suppl_9): ix74-ix78. 10.1093/annonc/mdy435
Authors S.Y. Huang, Y. Su, M. Hsieh, K. Rau
  • Hematology Oncology, Chang Gung Memorial Hospital-Kaohsiung, 833 - Kaohsiung/TW



Platinum-based chemotherapy is the standard treatment for metastatic urothelial carcinoma (mUC). However, there is limited data regarding elderly patients composed of increasing comorbidities could be assigned to “cisplatin-ineligibility”. This study was conducted to compare the efficacy and safety of carboplatin or cisplatin in elderly mUC patients.


The retrospective study enrolled elderly mUC patients (defined as age ≥ 70 years) who underwent 1st line platinum-based chemotherapy between July 2000 and December 2016. The primary end points were overall survival (OS) and progression free survival (PFS) calculated by Kaplan-Meier analysis. The secondary outcome was chemotherapy related adverse event (AE).


In total, 94 elderly mUC patients were enrolled and allocated into cisplatin or carboplatin group. The median OS was significantly prolonged in cisplatin group versus carboplatin group (13.5 vs. 5.8 months, HR 0.58, 95% CI 0.37-0.93, p = 0.02). Patients treated with carboplatin-based chemotherapy had significantly higher incidence of all grade 3 or worse AE (80.0 vs. 54.2%, p = 0.01) than those with cisplatin. AE related hospitalization (51.4 vs. 20.3%, p = 0.002) and treatment related deaths (20.0 vs. 5.1%, p = 0.02) were significantly increased in carboplatin group.


Elderly mUC patients treated with cisplatin-based chemotherapy had a survival benefit and better safety profiles than carboplatin. Age itself is not the crucial factor to determine cisplatin eligibility.

Editorial acknowledgement

Clinical trial identification

Legal entity responsible for the study

Yu-Li Su.


Has not received any funding.


All authors have declared no conflicts of interest.