Mp56-01 the effect of different concurrent chemotherapy regimens on outcomes in patients treated with radiation for muscle invasive bladder cancer

You have accessJournal of UrologyCME1 Apr 2023MP56-01 THE EFFECT OF DIFFERENT CONCURRENT CHEMOTHERAPY REGIMENS ON OUTCOMES IN PATIENTS TREATED WITH RADIATION FOR MUSCLE INVASIVE BLADDER CANCER Francis Lemire, Ronald Kool, Marcq Gautier, Robert Siemens, Bobby Shayegan, Michael Kim, Ionut Busca, Hamidreza Abdi, Mark Dawidek, Michael Uy, Gagan Fervaha, Fabio Cury, Nimira Alimohamed, Jonathan Izawa, Claudio Jeldres, Ricardo Rendon, Peter Black, Girish Kulkarni, Wassim Kassouf, and Rodney Breau Francis LemireFrancis Lemire More articles by this author , Ronald KoolRonald Kool More articles by this author , Marcq GautierMarcq Gautier More articles by this author , Robert SiemensRobert Siemens More articles by this author , Bobby ShayeganBobby Shayegan More articles by this author , Michael KimMichael Kim More articles by this author , Ionut BuscaIonut Busca More articles by this author , Hamidreza AbdiHamidreza Abdi More articles by this author , Mark DawidekMark Dawidek More articles by this author , Michael UyMichael Uy More articles by this author , Gagan FervahaGagan Fervaha More articles by this author , Fabio CuryFabio Cury More articles by this author , Nimira AlimohamedNimira Alimohamed More articles by this author , Jonathan IzawaJonathan Izawa More articles by this author , Claudio JeldresClaudio Jeldres More articles by this author , Ricardo RendonRicardo Rendon More articles by this author , Peter BlackPeter Black More articles by this author , Girish KulkarniGirish Kulkarni More articles by this author , Wassim KassoufWassim Kassouf More articles by this author , and Rodney BreauRodney Breau More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003309.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Radiotherapy is an accepted treatment approach for well-selected patients with bladder cancer. Randomized control trials have shown superior outcomes to patients who receive concurrent chemotherapy compared to radiation monotherapy. However, there are limited data to guide selection of the optimal radio-sensitizing regimen. METHODS: Canadian academic centres contributed to a retrospective cohort of muscle invasive (cT2-4N0-2) bladder cancer patients treated with curative-intent radiotherapy, with or without concurrent chemotherapy. Patients were stratified and analyzed by radio-sensitizing chemotherapy regimen. Outcomes were metastasis-free, cancer-specific, and overall survival (MFS, CSS, and OS). RESULTS: Of 656 patients, 268 (41%) were treated with radiation monotherapy, 174 (27%) with cisplatin, 108 (16%) with gemcitabine, 74 (11%) with 5FU-MMC, and 32 (5%) with carboplatin. The median follow-up was 24 months (95% CI: 21–27). In the entire cohort, the median MFS was 35 months (95% CI: 29–44), median CSS not reached (95% CI: 94–not reached) and median OS 52 months (95% CI 42–60). Disease characteristics were similar between groups, but patients who received radio-sensitizing chemotherapy were younger and had fewer comorbidities. Compared to no chemotherapy, concurrent cisplatin was associated with improved MFS (HR 0.46; 95% CI: 0.35-0.60), CSS (HR 0.44; 95% CI: 0.31-0.64) and OS (HR 0.33; 95% CI: 0.24-0.43). Concurrent 5FU-MMC was also associated with improved MFS (HR 0.60; 95% CI: 0.40-0.88), CSS (HR 0.32; 95% CI: 0.16-0.66), and OS (HR 0.45; 95% CI: 0.28-0.71). Concurrent gemcitabine was associated with improved MFS (HR 0.77; 95% CI 0.58-1.02), CCS (0.76; 95% CI 0.49-1.27), and OS (HR 0.76; 95% CI 0.57-1.02). Concurrent carboplatin was associated with improved MFS (HR 0.55; 95% CI: 0.33-0.92), CSS (HR 0.64; 0.43-1.27), and OS (HR 0.52; 95% CI: 0.30-0.89). CONCLUSIONS: Patients with MIBC treated with RT have better oncologic outcomes with all forms of radio-sensitizing chemotherapy. While the best outcomes are associated with cisplatin, other radiosensitizers seem to be effective for platinum-ineligible patients. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e773 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Francis Lemire More articles by this author Ronald Kool More articles by this author Marcq Gautier More articles by this author Robert Siemens More articles by this author Bobby Shayegan More articles by this author Michael Kim More articles by this author Ionut Busca More articles by this author Hamidreza Abdi More articles by this author Mark Dawidek More articles by this author Michael Uy More articles by this author Gagan Fervaha More articles by this author Fabio Cury More articles by this author Nimira Alimohamed More articles by this author Jonathan Izawa More articles by this author Claudio Jeldres More articles by this author Ricardo Rendon More articles by this author Peter Black More articles by this author Girish Kulkarni More articles by this author Wassim Kassouf More articles by this author Rodney Breau More articles by this author Expand All Advertisement PDF downloadLoading ...