{Reference Type}: Journal Article
{Title}: Optimal Number of Cycles of First-line Platinum-based Chemotherapy for Metastatic Urothelial Carcinoma.
{Author}: Minato A;Ohno D;Murooka K;Okumura Y;Takaba T;Higashijima K;Nagata Y;Tomisaki I;Harada K;Fujimoto N;
{Journal}: In Vivo
{Volume}: 38
{Issue}: 4
{Year}: 2024 Jul-Aug
{Factor}: 2.406
{DOI}: 10.21873/invivo.13648
{Abstract}: <B>OBJECTIVE: </B>In recent years, switch maintenance after platinum-based chemotherapy has been a standard of care. However, the appropriate number of systemic chemotherapy cycles against advanced-stage urothelial carcinoma (UC) remains unclear. This study assessed the survival outcomes of first-line platinum-based chemotherapy according to treatment cycles in patients with metastatic disease.<BR><B>METHODS: </B>We retrospectively evaluated patients with metastatic bladder and upper urinary tract cancer who received platinum-based combination therapy. Overall survival (OS) was evaluated using the Kaplan-Meier method and the log-rank test.<BR><B>RESULTS: </B>Of 179 patients, 47 (26.3%) were women, and 73 (40.8%) had upper urinary tract cancer. Furthermore, 47 (26.3%) who were not eligible for cisplatin received carboplatin. The median number of treatment cycles was 3 (range=1-14 cycles). The rates of progressive disease within two cycles, from two to four cycles, and from four to six cycles were 18.4%, 19.2%, and 30.6%, respectively. The median OS of patients with 2, 3, 4, 5-6, and ≥7 treatment cycles were 8.6, 14.3, 21.3, 24.4, and 26.1 months, respectively. The OS did not significantly differ between patients receiving four treatment cycles and those receiving ≥5 treatment cycles. In patients with disease control (complete or partial response or stable disease) receiving ≥4 treatment cycles, there was no significant difference in terms of OS between patients receiving four cycles and those receiving six cycles.<BR><B>CONCLUSIONS: </B>Four cycles of first-line platinum-based chemotherapy can be effective in patients with metastatic UC.