title: First-line treatment of metastatic disease: cisplatin-ineligible patients.
abstract: More than 50% of patients with advanced urothelial carcinoma are not eligible for the standard treatment with cisplatin-based chemotherapy. In general, cisplatin-ineligible patients with metastatic urothelial cancer experience poor outcomes with standard treatment, although substantial heterogeneity exists. Baseline variables associated with poor prognosis include borderline performance status, presence of visceral metastases, liver metastases, and low hemoglobin. Although no standard treatment has been defined for cisplatin-ineligible patients, recommendations regarding carboplatin-based combination chemotherapy versus single-agent chemotherapy versus best supportive care are typically based on performance status and renal function. The clinical development of novel agents is of considerable interest.
authors.affiliation: Division of Oncology/Hematology, Kantonsspital Graubünden, Chur CH-7000, Switzerland.
authors.forename: Richard
authors.initials: R
authors.lastname: Cathomas
authors.affiliation: Ludwig Boltzmann Institute for Applied Cancer Research (LBI-ACR VIEnna) - LBCTO, 3rd Medical Department, Centre for Oncology and Haematology, Kaiser Franz Josef Hospital, Vienna, Austria.
authors.forename: Maria
authors.initials: M
authors.lastname: De Santis
authors.affiliation: The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, 1470 Madison Avenue, New York, NY 10029, USA. Electronic address: matthew.galsky@mssm.edu.
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Galsky
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage; D002986:Clinical Trials as Topic; D057915:Drug Substitution; D006801:Humans; D009362:Neoplasm Metastasis; D011379:Prognosis; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology*
chemical_list: D002945:Cisplatin
keywords: Carboplatin; Gemcitabine; Prognostic factors; Unfit for cisplatin; Urothelial carcinoma