Neoadjuvant chemotherapy in urothelial bladder cancer: impact of regimen and variant histology

Hristos Z Kaimakliotis; M Francesca Monn; Jane S Cho; Jose A Pedrosa; Noah M Hahn; Costantine Albany; Paul T Gellhaus; K Clint Cary; Timothy A Masterson; Richard S Foster; Richard Bihrle; Liang Cheng; Michael O Koch

doi:10.2217/fon-2016-0056

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Neoadjuvant chemotherapy in urothelial bladder cancer: impact of regimen and variant histology

Journal article

Peer reviewed

Neoadjuvant chemotherapy in urothelial bladder cancer: impact of regimen and variant histology

Hristos Z Kaimakliotis, M Francesca Monn, Jane S Cho, Jose A Pedrosa, Noah M Hahn, Costantine Albany, Paul T Gellhaus, K Clint Cary, Timothy A Masterson, Richard S Foster, …

Future oncology (London, England), Vol.12(15), pp.1795-1804

08/2016

DOI: 10.2217/fon-2016-0056

PMID: 27255805

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Abstract

We compared the efficacy of methotrexate/vinblastine/doxorubicin/cisplatin (MVAC) versus gemcitabine/cisplatin in urothelial cancer and neoadjuvant chemotherapy (NACT) efficacy in variant histology (VH). Radical cystectomy patients were retrospectively compared with those who received NACT. Factors associated with survival, pathologic complete response (pCR) and downstaging (pDS) were evaluated in multivariable models. 9% of radical cystectomy patients (84/919) received NACT, with improved survival, pCR and pDS on both regimens. MVAC lead to higher pDS without an increase in pCR. On multivariable analysis, there was a nonsignificant increase in pDS with MVAC. NACT conferred similar responses in squamous and glandular differentiation VH. NACT was associated with improved survival, pCR and pDS. Furthermore, responses to NACT were not dependent on presence of VH.

Carcinoma, Transitional Cell - mortality

Humans

Middle Aged

Male

Vinblastine - administration & dosage

Cisplatin - administration & dosage

Vinblastine - adverse effects

Aged, 80 and over

Adult

Deoxycytidine - adverse effects

Female

Neoadjuvant Therapy

Retrospective Studies

Chemotherapy, Adjuvant

Doxorubicin - administration & dosage

Urinary Bladder Neoplasms - mortality

Deoxycytidine - administration & dosage

Kaplan-Meier Estimate

Proportional Hazards Models

Urinary Bladder Neoplasms - drug therapy

Disease-Free Survival

Methotrexate - adverse effects

Cystectomy

Antineoplastic Combined Chemotherapy Protocols - therapeutic use

Carcinoma, Transitional Cell - drug therapy

Cisplatin - adverse effects

Methotrexate - administration & dosage

Aged

Deoxycytidine - analogs & derivatives

Doxorubicin - adverse effects

Cohort Studies

Details

Title: Subtitle: Neoadjuvant chemotherapy in urothelial bladder cancer: impact of regimen and variant histology
Creators: Hristos Z Kaimakliotis - Department of Urology, Indiana University School of Medicine, 535 Barnhill Drive, Indianapolis, IN 46202, USA
M Francesca Monn - Department of Urology, Indiana University School of Medicine, 535 Barnhill Drive, Indianapolis, IN 46202, USA
Jane S Cho - Department of Urology, Indiana University School of Medicine, 535 Barnhill Drive, Indianapolis, IN 46202, USA
Jose A Pedrosa - Department of Urology, Indiana University School of Medicine, 535 Barnhill Drive, Indianapolis, IN 46202, USA
Noah M Hahn - Department of Genitourinary Medical Oncology, Johns Hopkins School of Medicine, 1550 Orleans Street, Room 1M51, Baltimore, MD 21287, USA
Costantine Albany - Department of Genitourinary Medical Oncology, Indiana University School of Medicine, 535 Barnhill Drive, Indianapolis, IN 46202, USA
Paul T Gellhaus - Department of Urology, Indiana University School of Medicine, 535 Barnhill Drive, Indianapolis, IN 46202, USA
K Clint Cary - Department of Urology, Indiana University School of Medicine, 535 Barnhill Drive, Indianapolis, IN 46202, USA
Timothy A Masterson - Department of Urology, Indiana University School of Medicine, 535 Barnhill Drive, Indianapolis, IN 46202, USA
Richard S Foster - Department of Urology, Indiana University School of Medicine, 535 Barnhill Drive, Indianapolis, IN 46202, USA
Richard Bihrle - Department of Urology, Indiana University School of Medicine, 535 Barnhill Drive, Indianapolis, IN 46202, USA
Liang Cheng - Department of Genitourinary Medical Oncology, Indiana University School of Medicine, 535 Barnhill Drive, Indianapolis, IN 46202, USA
Michael O Koch - Department of Urology, Indiana University School of Medicine, 535 Barnhill Drive, Indianapolis, IN 46202, USA
Resource Type: Journal article
Publication Details: Future oncology (London, England), Vol.12(15), pp.1795-1804
Publisher: England
DOI: 10.2217/fon-2016-0056
PMID: 27255805
ISSN: 1479-6694
eISSN: 1744-8301
Language: English
Date published: 08/2016
Academic Unit: Urology
Record Identifier: 9984051977602771

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