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Osterman CK , Babu DS , Geynisman DM , Lewis B , Somer RA , Balar AV , Zibelman MR , Guancial EA , Antinori G , Yu S , Narayan V , Guzzo TJ , Plimack ER , Vaughn DJ , Fung C , Mamtani R
Efficacy of Split Schedule Versus Conventional Schedule Neoadjuvant Cisplatin-Based Chemotherapy for Muscle-Invasive Bladder Cancer
Oncologist. 2019 May;24(5) :688-690
PMID: 30728277    PMCID: PMC6516116    URL: https://www.ncbi.nlm.nih.gov/pubmed/30728277
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Abstract
Neoadjuvant cisplatin-based chemotherapy (NAC; 70 mg/m(2)) is standard of care for muscle-invasive bladder carcinoma (MIBC). Many patients (pts) cannot receive cisplatin because of renal impairment, and administration of cisplatin 35 mg/m(2) on day 1 + 8 or 1 + 2 (i.e., split schedule) is a commonly used alternative. In this retrospective analysis, we compared complete (pT0) and partial (<pT2) pathologic response rates between split schedule (SS) and conventional schedule (CS) pts, after 1:1 matching on chemotherapy regimen, number of cycles, tumor histology, and clinical stage. Eighty matched pts were identified. pT0 rates were 17.5% (95% confidence interval [CI], 7%-33%) and 32.5% (95% CI, 19%-49%) in SS and CS cisplatin pts, respectively (p = .21), corresponding to an odds ratio for pT0 of 0.45 (95% CI, 0.16-1.31) with SS cisplatin. Split schedule cisplatin was associated with numerically but not statistically significant lower pathologic response rates relative to full dose.
Notes
1549-490x Osterman, Chelsea K Babu, Dilip S Geynisman, Daniel M Lewis, Bianca Somer, Robert A Balar, Arjun V Zibelman, Matthew R Guancial, Elizabeth A Antinori, Gianna Yu, Shun Narayan, Vivek Guzzo, Thomas J Plimack, Elizabeth R Vaughn, David J Fung, Chunkit Mamtani, Ronac Journal Article United States .Oncologist. 2019 May;24(5):688-690. doi: 10.1634/theoncologist.2018-0561. Epub 2019 Feb 6.