Current status of systemic chemotherapy for octogenarians with advanced urothelial cancer in Japan

a Japanese multi-institutional study (CURE study)

Yoshiyuki Matsui, Osamu Ogawa, Ryutaro Ishitsuka, Jun Miyazaki, Takamitsu Inoue, Susumu Kageyama, Mikio Sugimoto, Koji Mitsuzuka, Yusuke Shiraishi, Hidefumi Kinoshita, Hironobu Wakeda, Takeshi Nomoto, Eiji Kikuchi, Keiko Fujie, Naoto Keino, Hiroyuki Nishiyama

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: The standard regimen of systemic chemotherapy for patients with advanced urothelial cancer (UC) changed from methotrexate, vinblastine, adriamycin, and cisplatin (MVAC) to gemcitabine and cisplatin (GC) in 2008 when the use of gemcitabine for UC began to be reimbursed by public health insurance in Japan. We examined its influence on the chemotherapy trend in elderly patients aged ≥80 years. Methods: Among 345 patients included in our previous multicenter retrospective cohort study (chemotherapy for urothelial carcinoma: renal function and efficacy study; CURE study), the outcome of 30 patients aged ≥80 years was reviewed before and after 2008 and compared with 315 young patients. Results: There were only 7 (4.6 %) elderly individuals among all registered patients before 2008, whereas the number increased to 23 (12 %) after 2008. Before 2008, only one elderly patient received MVAC, while GC (whose rate was similar to the rate in young patients) was administered to 13 patients (56.5 %) after 2008. The chemotherapeutic effect and overall survival (OS) rate was not significantly different between young and elderly patients. In the elderly treated with the GC regimen, the renal impairment rate after the first cycle was significantly higher, and the presence of distant metastases and renal impairment were independent prognostic factors in a multivariate analysis. Conclusion: Since GC was approved as the standard regimen for first-line chemotherapy in UC, selected elderly patients have been able to safely receive systemic chemotherapy like young patients. The clinical response rate and OS rate were similar to the young, but we need to monitor changes in renal function more closely in the elderly treated with GC.

Original languageEnglish
Pages (from-to)1-8
Number of pages8
JournalInternational Journal of Clinical Oncology
DOIs
Publication statusAccepted/In press - 2016 Jun 27

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gemcitabine
Japan
Drug Therapy
Cisplatin
Neoplasms
Kidney
Vinblastine
Methotrexate
Doxorubicin
Survival Rate
Health Insurance
Cohort Studies
Multivariate Analysis
Retrospective Studies
Public Health
Outcome Assessment (Health Care)
Neoplasm Metastasis
Carcinoma

Keywords

  • Elderly
  • Outcome
  • Renal function
  • Systemic chemotherapy
  • Urothelial cancer

ASJC Scopus subject areas

  • Oncology
  • Surgery
  • Hematology

Cite this

Current status of systemic chemotherapy for octogenarians with advanced urothelial cancer in Japan : a Japanese multi-institutional study (CURE study). / Matsui, Yoshiyuki; Ogawa, Osamu; Ishitsuka, Ryutaro; Miyazaki, Jun; Inoue, Takamitsu; Kageyama, Susumu; Sugimoto, Mikio; Mitsuzuka, Koji; Shiraishi, Yusuke; Kinoshita, Hidefumi; Wakeda, Hironobu; Nomoto, Takeshi; Kikuchi, Eiji; Fujie, Keiko; Keino, Naoto; Nishiyama, Hiroyuki.

In: International Journal of Clinical Oncology, 27.06.2016, p. 1-8.

Research output: Contribution to journalArticle

Matsui, Y, Ogawa, O, Ishitsuka, R, Miyazaki, J, Inoue, T, Kageyama, S, Sugimoto, M, Mitsuzuka, K, Shiraishi, Y, Kinoshita, H, Wakeda, H, Nomoto, T, Kikuchi, E, Fujie, K, Keino, N & Nishiyama, H 2016, 'Current status of systemic chemotherapy for octogenarians with advanced urothelial cancer in Japan: a Japanese multi-institutional study (CURE study)', International Journal of Clinical Oncology, pp. 1-8. https://doi.org/10.1007/s10147-016-1007-8
Matsui, Yoshiyuki ; Ogawa, Osamu ; Ishitsuka, Ryutaro ; Miyazaki, Jun ; Inoue, Takamitsu ; Kageyama, Susumu ; Sugimoto, Mikio ; Mitsuzuka, Koji ; Shiraishi, Yusuke ; Kinoshita, Hidefumi ; Wakeda, Hironobu ; Nomoto, Takeshi ; Kikuchi, Eiji ; Fujie, Keiko ; Keino, Naoto ; Nishiyama, Hiroyuki. / Current status of systemic chemotherapy for octogenarians with advanced urothelial cancer in Japan : a Japanese multi-institutional study (CURE study). In: International Journal of Clinical Oncology. 2016 ; pp. 1-8.
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abstract = "Background: The standard regimen of systemic chemotherapy for patients with advanced urothelial cancer (UC) changed from methotrexate, vinblastine, adriamycin, and cisplatin (MVAC) to gemcitabine and cisplatin (GC) in 2008 when the use of gemcitabine for UC began to be reimbursed by public health insurance in Japan. We examined its influence on the chemotherapy trend in elderly patients aged ≥80 years. Methods: Among 345 patients included in our previous multicenter retrospective cohort study (chemotherapy for urothelial carcinoma: renal function and efficacy study; CURE study), the outcome of 30 patients aged ≥80 years was reviewed before and after 2008 and compared with 315 young patients. Results: There were only 7 (4.6 {\%}) elderly individuals among all registered patients before 2008, whereas the number increased to 23 (12 {\%}) after 2008. Before 2008, only one elderly patient received MVAC, while GC (whose rate was similar to the rate in young patients) was administered to 13 patients (56.5 {\%}) after 2008. The chemotherapeutic effect and overall survival (OS) rate was not significantly different between young and elderly patients. In the elderly treated with the GC regimen, the renal impairment rate after the first cycle was significantly higher, and the presence of distant metastases and renal impairment were independent prognostic factors in a multivariate analysis. Conclusion: Since GC was approved as the standard regimen for first-line chemotherapy in UC, selected elderly patients have been able to safely receive systemic chemotherapy like young patients. The clinical response rate and OS rate were similar to the young, but we need to monitor changes in renal function more closely in the elderly treated with GC.",
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T1 - Current status of systemic chemotherapy for octogenarians with advanced urothelial cancer in Japan

T2 - a Japanese multi-institutional study (CURE study)

AU - Matsui, Yoshiyuki

AU - Ogawa, Osamu

AU - Ishitsuka, Ryutaro

AU - Miyazaki, Jun

AU - Inoue, Takamitsu

AU - Kageyama, Susumu

AU - Sugimoto, Mikio

AU - Mitsuzuka, Koji

AU - Shiraishi, Yusuke

AU - Kinoshita, Hidefumi

AU - Wakeda, Hironobu

AU - Nomoto, Takeshi

AU - Kikuchi, Eiji

AU - Fujie, Keiko

AU - Keino, Naoto

AU - Nishiyama, Hiroyuki

PY - 2016/6/27

Y1 - 2016/6/27

N2 - Background: The standard regimen of systemic chemotherapy for patients with advanced urothelial cancer (UC) changed from methotrexate, vinblastine, adriamycin, and cisplatin (MVAC) to gemcitabine and cisplatin (GC) in 2008 when the use of gemcitabine for UC began to be reimbursed by public health insurance in Japan. We examined its influence on the chemotherapy trend in elderly patients aged ≥80 years. Methods: Among 345 patients included in our previous multicenter retrospective cohort study (chemotherapy for urothelial carcinoma: renal function and efficacy study; CURE study), the outcome of 30 patients aged ≥80 years was reviewed before and after 2008 and compared with 315 young patients. Results: There were only 7 (4.6 %) elderly individuals among all registered patients before 2008, whereas the number increased to 23 (12 %) after 2008. Before 2008, only one elderly patient received MVAC, while GC (whose rate was similar to the rate in young patients) was administered to 13 patients (56.5 %) after 2008. The chemotherapeutic effect and overall survival (OS) rate was not significantly different between young and elderly patients. In the elderly treated with the GC regimen, the renal impairment rate after the first cycle was significantly higher, and the presence of distant metastases and renal impairment were independent prognostic factors in a multivariate analysis. Conclusion: Since GC was approved as the standard regimen for first-line chemotherapy in UC, selected elderly patients have been able to safely receive systemic chemotherapy like young patients. The clinical response rate and OS rate were similar to the young, but we need to monitor changes in renal function more closely in the elderly treated with GC.

AB - Background: The standard regimen of systemic chemotherapy for patients with advanced urothelial cancer (UC) changed from methotrexate, vinblastine, adriamycin, and cisplatin (MVAC) to gemcitabine and cisplatin (GC) in 2008 when the use of gemcitabine for UC began to be reimbursed by public health insurance in Japan. We examined its influence on the chemotherapy trend in elderly patients aged ≥80 years. Methods: Among 345 patients included in our previous multicenter retrospective cohort study (chemotherapy for urothelial carcinoma: renal function and efficacy study; CURE study), the outcome of 30 patients aged ≥80 years was reviewed before and after 2008 and compared with 315 young patients. Results: There were only 7 (4.6 %) elderly individuals among all registered patients before 2008, whereas the number increased to 23 (12 %) after 2008. Before 2008, only one elderly patient received MVAC, while GC (whose rate was similar to the rate in young patients) was administered to 13 patients (56.5 %) after 2008. The chemotherapeutic effect and overall survival (OS) rate was not significantly different between young and elderly patients. In the elderly treated with the GC regimen, the renal impairment rate after the first cycle was significantly higher, and the presence of distant metastases and renal impairment were independent prognostic factors in a multivariate analysis. Conclusion: Since GC was approved as the standard regimen for first-line chemotherapy in UC, selected elderly patients have been able to safely receive systemic chemotherapy like young patients. The clinical response rate and OS rate were similar to the young, but we need to monitor changes in renal function more closely in the elderly treated with GC.

KW - Elderly

KW - Outcome

KW - Renal function

KW - Systemic chemotherapy

KW - Urothelial cancer

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