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Carboplatin Induction Chemotherapy in Clinically Lymph Node-positive Bladder Cancer

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Carboplatin Induction Chemotherapy in Clinically Lymph Node-positive Bladder Cancer. / von Deimling, Markus; Mertens, Laura S.; van Rhijn, Bas WG; Lotan, Yair; Spiess, Philippe E.; Daneshmand, Siamak; Black, Peter C.; Pallauf, Maximilian; D'Andrea, David; Moschini, Marco; Soria, Francesco; Del Giudice, Francesco; Afferi, Luca; Laukhtina, Ekaterina; Yanagisawa, Takafumi; Kawada, Tatsushi; Teoh, Jeremy Yuen-Chun; Abufaraj, Mohammad; Ploussard, Guillaume; Roumiguié, Mathieu; Karakiewicz, Pierre I; Babjuk, Marko; Gontero, Paolo; Xylinas, Evanguelous; Rink, Michael; Shariat, Shahrokh F; Pradere, Benjamin.

In: EUR UROL OPEN SCI, Vol. 51, 05.2023, p. 39-46.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

von Deimling, M, Mertens, LS, van Rhijn, BWG, Lotan, Y, Spiess, PE, Daneshmand, S, Black, PC, Pallauf, M, D'Andrea, D, Moschini, M, Soria, F, Del Giudice, F, Afferi, L, Laukhtina, E, Yanagisawa, T, Kawada, T, Teoh, JY-C, Abufaraj, M, Ploussard, G, Roumiguié, M, Karakiewicz, PI, Babjuk, M, Gontero, P, Xylinas, E, Rink, M, Shariat, SF & Pradere, B 2023, 'Carboplatin Induction Chemotherapy in Clinically Lymph Node-positive Bladder Cancer', EUR UROL OPEN SCI, vol. 51, pp. 39-46. https://doi.org/10.1016/j.euros.2023.02.014

APA

von Deimling, M., Mertens, L. S., van Rhijn, B. WG., Lotan, Y., Spiess, P. E., Daneshmand, S., Black, P. C., Pallauf, M., D'Andrea, D., Moschini, M., Soria, F., Del Giudice, F., Afferi, L., Laukhtina, E., Yanagisawa, T., Kawada, T., Teoh, J. Y-C., Abufaraj, M., Ploussard, G., ... Pradere, B. (2023). Carboplatin Induction Chemotherapy in Clinically Lymph Node-positive Bladder Cancer. EUR UROL OPEN SCI, 51, 39-46. https://doi.org/10.1016/j.euros.2023.02.014

Vancouver

von Deimling M, Mertens LS, van Rhijn BWG, Lotan Y, Spiess PE, Daneshmand S et al. Carboplatin Induction Chemotherapy in Clinically Lymph Node-positive Bladder Cancer. EUR UROL OPEN SCI. 2023 May;51:39-46. https://doi.org/10.1016/j.euros.2023.02.014

Bibtex

@article{2497f89c1f9040739cb3c960a5cd0b95,
title = "Carboplatin Induction Chemotherapy in Clinically Lymph Node-positive Bladder Cancer",
abstract = "BACKGROUND: There are currently no guideline recommendations regarding the treatment of cisplatin-ineligible, clinically lymph node-positive (cN+) bladder cancer (BCa).OBJECTIVE: To investigate the oncological efficacy of gemcitabine/carboplatin induction chemotherapy (IC) in comparison to cisplatin-based regimens in cN+ BCa.DESIGN SETTING AND PARTICIPANTS: This was an observational study of 369 patients with cT2-4 N1-3 M0 BCa.INTERVENTION: IC followed by consolidative radical cystectomy (RC).OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The primary endpoints were the pathological objective response (pOR; ypT0/Ta/Tis/T1 N0) rate and the pathological complete response (pCR; ypT0N0) rate. We applied 3:1 propensity score matching (PSM) to reduce selection bias. Overall survival (OS) and cancer-specific survival (CSS) were compared across groups using the Kaplan-Meier method. Associations between the treatment regimen and survival endpoints were tested in multivariable Cox regression analyses.RESULTS AND LIMITATIONS: After PSM, a cohort of 216 patients was available for analysis, of whom 162 received cisplatin-based IC and 54 gemcitabine/carboplatin IC. At RC, 54 patients (25%) had a pOR and 36 (17%) had a pCR. The 2-yr CSS was 59.8% (95% confidence interval [CI] 51.9-69%) for patients who received cisplatin-based IC versus 38.8% (95% CI 26-57.9%) for those who received gemcitabine/carboplatin. For the pOR (p = 0.8), ypN0 status at RC (p = 0.5), and cN1 BCa subgroups (p = 0.7), there was no difference in CSS between cisplatin-based IC and gemcitabine/carboplatin. In the cN1 subgroup, treatment with gemcitabine/carboplatin was not associated with shorter OS (p = 0.2) or CSS (p = 0.1) on multivariable Cox regression analysis.CONCLUSIONS: Cisplatin-based IC seems to be superior to gemcitabine/carboplatin and should be the standard for cisplatin-eligible patients with cN+ BCa. Gemcitabine/carboplatin may be an alternative treatment for selected cisplatin-ineligible patients with cN+ BCa. In particular, selected cisplatin-ineligible patients with cN1 disease may benefit from gemcitabine/carboplatin IC.PATIENT SUMMARY: In this multicenter study, we found that selected patients with bladder cancer and clinical evidence of lymph node metastasis who cannot receive standard cisplatin-based chemotherapy before surgery to remove their bladder may benefit from chemotherapy with gemcitabine/carboplatin. Patients with a single lymph node metastasis may benefit the most.",
author = "{von Deimling}, Markus and Mertens, {Laura S.} and {van Rhijn}, {Bas WG} and Yair Lotan and Spiess, {Philippe E.} and Siamak Daneshmand and Black, {Peter C.} and Maximilian Pallauf and David D'Andrea and Marco Moschini and Francesco Soria and {Del Giudice}, Francesco and Luca Afferi and Ekaterina Laukhtina and Takafumi Yanagisawa and Tatsushi Kawada and Teoh, {Jeremy Yuen-Chun} and Mohammad Abufaraj and Guillaume Ploussard and Mathieu Roumigui{\'e} and Karakiewicz, {Pierre I} and Marko Babjuk and Paolo Gontero and Evanguelous Xylinas and Michael Rink and Shariat, {Shahrokh F} and Benjamin Pradere",
year = "2023",
month = may,
doi = "10.1016/j.euros.2023.02.014",
language = "English",
volume = "51",
pages = "39--46",
journal = "EUR UROL OPEN SCI",
issn = "2666-1691",
publisher = "Elsevier BV",

}

RIS

TY - JOUR

T1 - Carboplatin Induction Chemotherapy in Clinically Lymph Node-positive Bladder Cancer

AU - von Deimling, Markus

AU - Mertens, Laura S.

AU - van Rhijn, Bas WG

AU - Lotan, Yair

AU - Spiess, Philippe E.

AU - Daneshmand, Siamak

AU - Black, Peter C.

AU - Pallauf, Maximilian

AU - D'Andrea, David

AU - Moschini, Marco

AU - Soria, Francesco

AU - Del Giudice, Francesco

AU - Afferi, Luca

AU - Laukhtina, Ekaterina

AU - Yanagisawa, Takafumi

AU - Kawada, Tatsushi

AU - Teoh, Jeremy Yuen-Chun

AU - Abufaraj, Mohammad

AU - Ploussard, Guillaume

AU - Roumiguié, Mathieu

AU - Karakiewicz, Pierre I

AU - Babjuk, Marko

AU - Gontero, Paolo

AU - Xylinas, Evanguelous

AU - Rink, Michael

AU - Shariat, Shahrokh F

AU - Pradere, Benjamin

PY - 2023/5

Y1 - 2023/5

N2 - BACKGROUND: There are currently no guideline recommendations regarding the treatment of cisplatin-ineligible, clinically lymph node-positive (cN+) bladder cancer (BCa).OBJECTIVE: To investigate the oncological efficacy of gemcitabine/carboplatin induction chemotherapy (IC) in comparison to cisplatin-based regimens in cN+ BCa.DESIGN SETTING AND PARTICIPANTS: This was an observational study of 369 patients with cT2-4 N1-3 M0 BCa.INTERVENTION: IC followed by consolidative radical cystectomy (RC).OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The primary endpoints were the pathological objective response (pOR; ypT0/Ta/Tis/T1 N0) rate and the pathological complete response (pCR; ypT0N0) rate. We applied 3:1 propensity score matching (PSM) to reduce selection bias. Overall survival (OS) and cancer-specific survival (CSS) were compared across groups using the Kaplan-Meier method. Associations between the treatment regimen and survival endpoints were tested in multivariable Cox regression analyses.RESULTS AND LIMITATIONS: After PSM, a cohort of 216 patients was available for analysis, of whom 162 received cisplatin-based IC and 54 gemcitabine/carboplatin IC. At RC, 54 patients (25%) had a pOR and 36 (17%) had a pCR. The 2-yr CSS was 59.8% (95% confidence interval [CI] 51.9-69%) for patients who received cisplatin-based IC versus 38.8% (95% CI 26-57.9%) for those who received gemcitabine/carboplatin. For the pOR (p = 0.8), ypN0 status at RC (p = 0.5), and cN1 BCa subgroups (p = 0.7), there was no difference in CSS between cisplatin-based IC and gemcitabine/carboplatin. In the cN1 subgroup, treatment with gemcitabine/carboplatin was not associated with shorter OS (p = 0.2) or CSS (p = 0.1) on multivariable Cox regression analysis.CONCLUSIONS: Cisplatin-based IC seems to be superior to gemcitabine/carboplatin and should be the standard for cisplatin-eligible patients with cN+ BCa. Gemcitabine/carboplatin may be an alternative treatment for selected cisplatin-ineligible patients with cN+ BCa. In particular, selected cisplatin-ineligible patients with cN1 disease may benefit from gemcitabine/carboplatin IC.PATIENT SUMMARY: In this multicenter study, we found that selected patients with bladder cancer and clinical evidence of lymph node metastasis who cannot receive standard cisplatin-based chemotherapy before surgery to remove their bladder may benefit from chemotherapy with gemcitabine/carboplatin. Patients with a single lymph node metastasis may benefit the most.

AB - BACKGROUND: There are currently no guideline recommendations regarding the treatment of cisplatin-ineligible, clinically lymph node-positive (cN+) bladder cancer (BCa).OBJECTIVE: To investigate the oncological efficacy of gemcitabine/carboplatin induction chemotherapy (IC) in comparison to cisplatin-based regimens in cN+ BCa.DESIGN SETTING AND PARTICIPANTS: This was an observational study of 369 patients with cT2-4 N1-3 M0 BCa.INTERVENTION: IC followed by consolidative radical cystectomy (RC).OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The primary endpoints were the pathological objective response (pOR; ypT0/Ta/Tis/T1 N0) rate and the pathological complete response (pCR; ypT0N0) rate. We applied 3:1 propensity score matching (PSM) to reduce selection bias. Overall survival (OS) and cancer-specific survival (CSS) were compared across groups using the Kaplan-Meier method. Associations between the treatment regimen and survival endpoints were tested in multivariable Cox regression analyses.RESULTS AND LIMITATIONS: After PSM, a cohort of 216 patients was available for analysis, of whom 162 received cisplatin-based IC and 54 gemcitabine/carboplatin IC. At RC, 54 patients (25%) had a pOR and 36 (17%) had a pCR. The 2-yr CSS was 59.8% (95% confidence interval [CI] 51.9-69%) for patients who received cisplatin-based IC versus 38.8% (95% CI 26-57.9%) for those who received gemcitabine/carboplatin. For the pOR (p = 0.8), ypN0 status at RC (p = 0.5), and cN1 BCa subgroups (p = 0.7), there was no difference in CSS between cisplatin-based IC and gemcitabine/carboplatin. In the cN1 subgroup, treatment with gemcitabine/carboplatin was not associated with shorter OS (p = 0.2) or CSS (p = 0.1) on multivariable Cox regression analysis.CONCLUSIONS: Cisplatin-based IC seems to be superior to gemcitabine/carboplatin and should be the standard for cisplatin-eligible patients with cN+ BCa. Gemcitabine/carboplatin may be an alternative treatment for selected cisplatin-ineligible patients with cN+ BCa. In particular, selected cisplatin-ineligible patients with cN1 disease may benefit from gemcitabine/carboplatin IC.PATIENT SUMMARY: In this multicenter study, we found that selected patients with bladder cancer and clinical evidence of lymph node metastasis who cannot receive standard cisplatin-based chemotherapy before surgery to remove their bladder may benefit from chemotherapy with gemcitabine/carboplatin. Patients with a single lymph node metastasis may benefit the most.

U2 - 10.1016/j.euros.2023.02.014

DO - 10.1016/j.euros.2023.02.014

M3 - SCORING: Journal article

C2 - 37187719

VL - 51

SP - 39

EP - 46

JO - EUR UROL OPEN SCI

JF - EUR UROL OPEN SCI

SN - 2666-1691

ER -