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Poster display session

2720 - Impact of cisplatin-based therapy on long-term survival in advanced urinary tract cancer (aUTC). A Retrospective International Study of Invasive/advanced cancer of the urothelium (RISC).

Date

10 Sep 2017

Session

Poster display session

Topics

Cytotoxic Therapy;  Urothelial Cancers

Presenters

Aristotelis Bamias

Citation

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

Authors

A. Bamias1, K. Tzannis1, C. Bamia2, L.C. Harshman3, S. Crabb4, Y. Wong5, S.K. Pal6, U. De Giorgi7, S. Ladoire8, N. Agarwal9, E.Y. Yu10, G. Niegisch11, C.N. Sternberg12, A. Srinivas13, U. Vaishampayan14, A. Necchi15, J.E. Rosenberg16, T. Powles17, J. Bellmunt18, M.D. Galsky19

Author affiliations

  • 1 Clinical Therapeutics, National and Kapodistrian University of Athens, 115 28 - Athens/GR
  • 2 Department Of Hygiene, Epidemiology And Medical Statistics, National and Kapodistrian University of Athens, Medical School, Athens/GR
  • 3 Genitourinary Oncology, Dana-Farber Cancer Institute, 2215 - Boston/US
  • 4 Medical Oncology, Southampton General Hospital Southampton University Hospitals NHS Trust, SO16 6YD - Southampton/GB
  • 5 Medical Oncology, Fox Chase Cancer Center, Philadelphia/US
  • 6 Medical Oncology, City of Hope, 91010 - Duarte/US
  • 7 Medical Oncology, Istituto Tumori della Romagna I.R.S.T., 47014 - Meldola/IT
  • 8 Medical Oncology, Centre Georges-François Leclerc (Dijon), 21000 - Dijon/FR
  • 9 Medical Oncology, Huntsman Cancer Institute, 84112 - Salt Lake City/US
  • 10 Medicine, University of Washington, Seattle/US
  • 11 Department Of Urology, Heinrich-Heine-University Düsseldorf, 40225 - Düsseldorf/DE
  • 12 Department Of Oncology, San Camillo and Forlanini Hospitals, 156 - Roma/IT
  • 13 Medical Oncology, Stanford University, Stanford/US
  • 14 Solid Tumor Oncology, Wayne State University, Karmanos Cancer Center, Detroit/US
  • 15 Medical Oncology, Fondazione IRCCS - Istituto Nazionale dei Tumori, 20133 - Milan/IT
  • 16 Oncology, Memorial Sloan-Kettering Cancer Center, 10065 - New York/US
  • 17 Barts Cancer Institute, Queen Mary University of London, London/GB
  • 18 Lank Center For Genitourinary Oncology, Dana-Farber Cancer Institute, 02215 - Boston/US
  • 19 Department Of Medicine, Icahn School of Medicine at Mount Sinai, New York/US
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Abstract 2720

Background

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.

Methods

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.

Results

1361 patients (median fup: 31 months) were analysed. Survival analyses are shown in the table.Table:

866P

Probability of surviving (y) (%)
345
Received Cisplatin (n = 689) Did not receive cisplatin (n = 672)28 1323 1019 6
FFC (n = 421) Unfit (n = 550)28 1322 1018 8
Received Cisplatin/Fit (n = 295) Did not receive cisplatin/unfit (n = 368)34 1128 1028 6
Probability of surviving 2 more years having lived (y) (observed/predicted) (%)
123
Received Cisplatin Did not receive cisplatin44/43 30/3254/62 48/4762/67 43/57
FFC Unfit45/43 31/3264/60 56/5364/69 61/66
Received Cisplatin/Fit Did not receive cisplatin/unfit49/49 29/3267/65 57/5582/74 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.

Conclusions

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

RISC investigators

Funding

None

Disclosure

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.

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