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Cheeseman S, Thompson M, Sopwith W, Godden P, Seshagiri D, Adedokun L, Zucker K, Jain S, Kotwal S, Prescott S, Henry A, Joseph J, Chilka S, Roulson JA, Weston M, Burbidge S, Brown S, Jagdev S, Ralph C, Hall G, Vasudev NS. Current Treatment and Outcomes Benchmark for Locally Advanced or Metastatic Urothelial Cancer From a Large UK-Based Single Centre. Front Oncol 2020; 10:167. [PMID: 32154169 PMCID: PMC7044411 DOI: 10.3389/fonc.2020.00167] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 01/30/2020] [Indexed: 01/14/2023] Open
Abstract
Objectives: To characterize treatment patterns and survival outcomes for patients with locally advanced or metastatic malignancy of the urothelial tract during a period immediately preceding the widespread use of immune checkpoint inhibitors in the UK. Patients and Methods: We retrospectively examined the electronic case notes of patients attending the Leeds Cancer Center, UK with locally advanced or metastatic urothelial carcinoma, receiving chemotherapy between January 2003 and March 2017. Patient characteristics, treatment patterns, and outcomes were collected. Summary and descriptive statistics were calculated for categorical and continuous variables as appropriate. The Kaplan–Meier method was used to estimate median survival and Cox regression proportional hazards model was used to explore relationships between clinical variables and outcome. Results: Two hundred and sixteen patients made up the study cohort, with a median age of 66 years (range: 35–83) and 72.7% being male. First-line treatment consisted of either a cisplatin- (44%) or carboplatin-based regimen (48%) in the majority of patients. Twenty seven percent of patients received a second-line of treatment (most commonly single-agent paclitaxel) following a first-line platinum containing regimen. Grade 4 neutropenia was observed in 19 and 27% of those treated with a first-line cisplatin- and carboplatin-based regimen, respectively. The median overall survival (mOS) of the study cohort was estimated to be 16.2 months (IQR: 10.6–28.3 months). Receipt by patients of cisplatin-based chemotherapy was associated with a longer mOS and this association persisted when survival analysis was adjusted for age, sex, performance status and presence of distant metastases. Conclusions: This study provides a useful benchmark for outcomes achieved in a real-world setting for patients with locally advanced or metastatic UC treated with chemotherapy in the immediate pre-immunotherapy era.
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Affiliation(s)
- Sue Cheeseman
- Leeds Cancer Centre, St James's University Hospital, Leeds, United Kingdom
| | - Matthew Thompson
- Leeds Cancer Centre, St James's University Hospital, Leeds, United Kingdom
| | - Will Sopwith
- Leeds Cancer Centre, St James's University Hospital, Leeds, United Kingdom.,IQVIA, London, United Kingdom
| | - Paul Godden
- Leeds Cancer Centre, St James's University Hospital, Leeds, United Kingdom.,IQVIA, London, United Kingdom
| | | | | | - Kieran Zucker
- Leeds Cancer Centre, St James's University Hospital, Leeds, United Kingdom
| | - Sunjay Jain
- Leeds Cancer Centre, St James's University Hospital, Leeds, United Kingdom
| | - Sanjeev Kotwal
- Leeds Cancer Centre, St James's University Hospital, Leeds, United Kingdom
| | - Stephen Prescott
- Leeds Cancer Centre, St James's University Hospital, Leeds, United Kingdom
| | - Ann Henry
- Leeds Cancer Centre, St James's University Hospital, Leeds, United Kingdom
| | - Joji Joseph
- Leeds Cancer Centre, St James's University Hospital, Leeds, United Kingdom
| | - Sameer Chilka
- Leeds Cancer Centre, St James's University Hospital, Leeds, United Kingdom
| | - Jo-An Roulson
- Leeds Cancer Centre, St James's University Hospital, Leeds, United Kingdom
| | - Michael Weston
- Leeds Cancer Centre, St James's University Hospital, Leeds, United Kingdom
| | - Simon Burbidge
- Leeds Cancer Centre, St James's University Hospital, Leeds, United Kingdom
| | - Simon Brown
- Bradford Royal Infirmary, Bradford, United Kingdom
| | - Satinder Jagdev
- Leeds Cancer Centre, St James's University Hospital, Leeds, United Kingdom
| | - Christy Ralph
- Leeds Cancer Centre, St James's University Hospital, Leeds, United Kingdom
| | - Geoff Hall
- Leeds Cancer Centre, St James's University Hospital, Leeds, United Kingdom.,School of Medicine, University of Leeds, Leeds, United Kingdom
| | - Naveen S Vasudev
- Leeds Cancer Centre, St James's University Hospital, Leeds, United Kingdom.,School of Medicine, University of Leeds, Leeds, United Kingdom
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