Sonpavde GP, et al. - Authors assessed the effect of < 6 cycles of platinum-based first-line chemotherapy vs the conventional ≥ 6 on survival of metastatic urothelial carcinoma (UC). Experts noted that four cycles of platinum based first-line chemotherapy were satisfactory and survival of patients with advanced UC was not significantly compromised. Unnecessary cumulative toxicities could be avoided by the omission of excessive cycles and as well as a better transition to second-line therapy and investigational switch maintenance therapy strategies.

Methods

• Experts employed the Retrospective International Study of Invasive/Advanced Cancer of the Urothelium (RISC) database.
• They gauged the association of the number of cycles of chemotherapy with overall survival (OS) by Cox multiple regression analysis, after controlling for recognized prognostic factors.
• The patients receiving < 3 or > 9 cycles of platinum chemotherapy were excluded to reduce confounding factors.

Results

• Findings suggested that out of 1,020 patients in RISC, 472 who received cisplatin (n=338) or carboplatin (n=134) were could be evaluated.
• As per data, 3-5 cycles (median 4) were received by 157 patients and 6-9 cycles (median 6) were received by 315.
• OS was not significantly different between 3-5 and 6-9 cycles (HR 1.02, 95%CI: 0.78-1.33, p=0.91).