In:
Oncology, S. Karger AG, Vol. 73, No. 5-6 ( 2007), p. 290-297
Abstract:
〈 i 〉 Objective: 〈 /i 〉 We evaluated safety and efficacy of first-line gemcitabine/carboplatin in unfit-for-cisplatin patients with advanced urothelial carcinoma and the effect on the quality of life and functional status of elderly patients (aged 〉 70). 〈 i 〉 Methods: 〈 /i 〉 Unfit patients had ECOG performance status (PS) ≧2, creatinine clearance 〈 50 ml/min or comorbidities precluding cisplatin administration. Carboplatin at area under the curve of 2.5 and gemcitabine 1,250 mg/m 〈 sup 〉 2 〈 /sup 〉 were administered biweekly. Elderly patients were stratified into group 1 (no activities of daily living (ADL) or instrumental ADL dependency and no comorbidities), group 2 (instrumental ADL dependency or 1–2 comorbidities) and group 3 (ADL dependency or ≧2 comorbidities). 〈 i 〉 Results: 〈 /i 〉 Thirty-four patients were enrolled: 68% had PS 2–3, 69% a creatinine clearance 〈 50 ml/min and 65% had 1 or more comorbidities. There were 3 cases of grade 3 toxicity (9%). Response rate was 24% [95% confidence interval (CI) 11–41]. Median follow-up was 8 months, median progression-free survival 4.4 months (95% CI 1.03–7.75) and median overall survival 9.8 months (95% CI 4.7–14.9). Patients in geriatric assessment groups 1 and 2 had a significantly longer median progression-free survival compared to group 3 [6.9 months (95% CI 1.3–12.4) vs. 1.9 months (95% CI 0.5–3.2); p = 0.005] . 〈 i 〉 Conclusion: 〈 /i 〉 First-line gemcitabine/carboplatin combination is active in unfit-for-cisplatin patients with advanced urothelial carcinoma. Pretreatment quality of life and geriatric assessment may be useful in selecting patients likely to benefit from this treatment.
Type of Medium:
Online Resource
ISSN:
0030-2414
,
1423-0232
Language:
English
Publisher:
S. Karger AG
Publication Date:
2007
detail.hit.zdb_id:
1483096-6
detail.hit.zdb_id:
250101-6
Permalink