title: Cisplatin-based combination chemotherapy in septuagenarians with metastatic urothelial cancer.
abstract: OBJECTIVE
  Cisplatin-based chemotherapy is standard first-line treatment for metastatic urothelial carcinoma. However, cisplatin is frequently avoided in elderly patients due to concerns regarding toxicities. We analyzed the efficacy, and tolerability, of cisplatin-based chemotherapy in elderly patients.
  
  
  METHODS
  Individual patient data were pooled from 8 phase II and III trials evaluating cisplatin-based first-line chemotherapy in patients with metastatic urothelial carcinoma. Adverse events, treatment delivery, response proportions, and survival outcomes were compared between patients aged<70 vs. ≥ 70 years.
  
  
  RESULTS
  Of the 543 patients included, 162 patients (30%) were ≥ 70 years old. The majority (93%) of elderly patients were aged 70 to 79 years. There was no significant difference in the proportions of patients experiencing Grade 3 to 4 renal failure, febrile neutropenia, or treatment-related death between younger and older patient cohorts. The median survival of the patients ≥ 70 years was 12.1 months compared to 12.8 months for patients<70 years (P = 0.91). There was no significant difference in survival between age groups when controlling for baseline performance status or the presence of visceral metastases or both.
  
  
  CONCLUSIONS
  Fit septuagenarians, with adequate renal function, tolerate cisplatin-based chemotherapy similarly to their younger counterparts and achieve comparable clinical outcomes.
authors: The Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY. Electronic address: matthew.galsky@mssm.edu.
authors: Matthew D
authors: MD
authors: Galsky
authors: Urologische Klinik, Alexianer Krefeld GmbH, Krefeld, Germany.
authors: Susan
authors: S
authors: Krege
authors: Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan.
authors: Chia-Chi
authors: CC
authors: Lin
authors: Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN.
authors: Noah
authors: N
authors: Hahn
authors: HELIOS Hospital, Bad Saarow, Germany.
authors: Thorsten H
authors: TH
authors: Ecke
authors: The Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY.
authors: Erin
authors: E
authors: Moshier
authors: US Oncology Research, LLC, McKesson Specialty Health, The Woodlands, TX; Texas Oncology, Webster, TX.
authors: Guru
authors: G
authors: Sonpavde
authors: The Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY.
authors: James
authors: J
authors: Godbold
authors: The Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY.
authors: William K
authors: WK
authors: Oh
authors: University of Athens & Hellenic Cooperative Oncology Group, Athens, Greece.
authors: Aristotle
authors: A
authors: Bamias
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage*; D017322:Clinical Trials, Phase II as Topic; D017326:Clinical Trials, Phase III as Topic; D015331:Cohort Studies; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D016019:Survival Analysis; D016896:Treatment Outcome; D014571:Urologic Neoplasms / Q000188:drug therapy*; D019459:Urothelium / Q000473:pathology*
chemical_list: D000970:Antineoplastic Agents; D002945:Cisplatin
keywords: Bladder neoplasm; Cisplatin; Elderly; Metastatic; Urothelial neoplasm