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Poster display session

2584 - Outcomes of patients with metastatic urothelial carcinoma (mUC) with exclusive bone metastases: focus on a special patient population

Date

10 Sep 2017

Session

Poster display session

Presenters

Andrea Necchi

Citation

Annals of Oncology (2017) 28 (suppl_5): v295-v329. 10.1093/annonc/mdx371

Authors

A. Necchi1, G.R. Pond2, S.K. Pal3, N. Agarwal4, D. Bowles5, E.R. Plimack6, E.Y. Yu7, S. Ladoire8, J. Baniel9, S. Crabb10, G. Niegisch11, A.R. Golshayan12, S. Sridhar13, D. Berthold14, J.E. Rosenberg15, T. Powles16, A. Bamias17, L.C. Harshman18, J. Bellmunt19, M.D. Galsky20

Author affiliations

  • 1 Medical Oncology, Fondazione IRCCS - Istituto Nazionale dei Tumori, 20133 - Milan/IT
  • 2 Biostatistics, McMaster University, Hamilton/CA
  • 3 Medicine, City of Hope, 91010 - Duarte/US
  • 4 Medical Oncology, Huntsman Cancer Institute, 84112 - Salt Lake City/US
  • 5 Medical Oncology, University of Colorado Denver, 80045 - South Aurora/US
  • 6 Medical Oncology, Fox Chase Cancer Center, 19111-2497 - Philadelphia/US
  • 7 Medicine, University of Washington, Seattle/US
  • 8 Medical Oncology, Centre Georges-François Leclerc (Dijon), 21000 - Dijon/FR
  • 9 Medical Oncology, Rabin Medical Center, Petach Tikva/IL
  • 10 Medical Oncology, Southampton General Hospital Southampton University Hospitals NHS Trust, SO16 6YD - Southampton/GB
  • 11 Urology, Heinrich-Heine-University Düsseldorf, 40225 - Düsseldorf/DE
  • 12 Medical Oncology, Medical University of South Carolina, Charleston/US
  • 13 Medical Oncology, Princess Margaret Hospital, M5G 2M9 - Toronto/CA
  • 14 Medical Oncology, Centre Hospitalier Universitaire Vaudois - CHUV, 1011 - Lausanne/CH
  • 15 Genitourinary Oncology Section, Memorial Sloan-Kettering Cancer Center, 10065 - New York/US
  • 16 Oncology, St. Bartholomew's Hospital, EC1A 7BE - London/GB
  • 17 Therapeutics Oncology, National and Kapodistrian University of Athens, Athens/GR
  • 18 Medical Oncology, Dana-Farber Cancer Institute, 2215 - Boston/US
  • 19 Genitourinary Oncology, Dana-Farber Cancer Institute , Boston, MA/US
  • 20 Medical Oncology, Icahn School of Medicine at Mount Sinai, New York/US
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Resources

Abstract 2584

Background

Patients (pts) with aUC with exclusive bone metastatic spread represent a rare subgroup of pts with unique clinical features. These pts deserve special consideration, as they are usually excluded from clinical trials due to the lack of measurable disease according to RECIST criteria. We focused on their access to treatment and outcomes in a retrospective study.

Methods

Cases were extracted from the pool of 1,911 pts with a diagnosis of mUC from the RISC database (db). Data from 23 centers was collected. Results of 1st-line, platinum-based chemotherapy in bone-only pts were compared with those from the remaining pts in the RISC db. Summary statistics were used to describe pt characteristics and outcomes. Kaplan-Meier method was used to estimate time to event outcomes such as progression-free survival (PFS) and overall survival (OS). Both OS and PFS are measured from the date of diagnosis of metastatic disease. Univariable and multivariable Cox analyses were performed. All tests were two-sided and statistical significance was defined as a p-value ≤0.05.

Results

A total of 128 evaluable pts (6.7%), treated between 02/1997 and 04/2013, were identified. ECOG-PS was ≥1 in 85.9% vs. 66.3% of the remaining pts from RISC db. 73 (57%) received 1st-line chemotherapy, that was platinum-based in all pts, and 28 of them (38.4%) 2nd-line CT (vs. 75.8% and 42.5%, respectively, from the RISC db). On multivariable analyses, only the chemotherapy administration was significantly associated with improved OS among bone-only mUC pts (p 

Conclusions

Pts with bone only metastases are less likely to receive systemic therapy than pts with metastases to other sites, likely due to lower PS. The prognostic impact of having exclusive bone metastases or additional sites seems to be equally poor. Clinical trials with new agents should focus on this population.

Clinical trial identification

Legal entity responsible for the study

Andrea Necchi

Funding

None

Disclosure

All authors have declared no conflicts of interest.

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