Cisplatin-based chemotherapy is the treatment of choice in aUTC. Nevertheless, about 50% of patients are unfit for this treatment. Long-term survival of patients with aUTC has not been adequately studied outside the context of clinical trials. In addition, the impact of cisplatin utilization on long-term survival has not been adequately addressed. We used a multinational database to study long-term survival and the impact of treatment type in unselected aUTC patients as well as to provide benchmarks for future trials.
Selection criteria: Diagnosis of aUTC, non small-cell histologies, administration of 1st-line chemotherapy, survival data available. Major end point: Overall survival (OS). Fitness-for-cisplatin (FFC) was defined according to Galsky et al (2011). Landmark and conditional survival analysis was used to study the change of prognosis with time from initiation of 1st-line chemotherapy.
1361 patients (median fup: 31 months) were analysed. Survival analyses are shown in the table.Table:
|Probability of surviving (y) (%)|
|Received Cisplatin (n = 689) Did not receive cisplatin (n = 672)||28 13||23 10||19 6|
|FFC (n = 421) Unfit (n = 550)||28 13||22 10||18 8|
|Received Cisplatin/Fit (n = 295) Did not receive cisplatin/unfit (n = 368)||34 11||28 10||28 6|
|Probability of surviving 2 more years having lived (y) (observed/predicted) (%)|
|Received Cisplatin Did not receive cisplatin||44/43 30/32||54/62 48/47||62/67 43/57|
|FFC Unfit||45/43 31/32||64/60 56/53||64/69 61/66|
|Received Cisplatin/Fit Did not receive cisplatin/unfit||49/49 29/32||67/65 57/55||82/74 58/68|
Cisplatin therapy and FFC were associated with improved long-term survival. FFC patients have a 28% probability of 5-year survival, which is increased to 74% for the 34% of patients who survive 3-years after initiation of cisplatin-based chemotherapy.
Published criteria for FFC accurately predict for long-term survival of aUTC patients, following cisplatin-based chemotherapy, while patients not treated with cisplatin have inferior outcome. Probability of long-term survival was increased with time after initiation of 1st-line (cisplatin or no-cisplatin) therapy.
Clinical trial identification
Legal entity responsible for the study
Y-N. Wong: The author was at Fox Chase Cancer Center at the time the study was conducted but is now a Janssen Scientific Affairs employee. All other authors have declared no conflicts of interest.