title: Treatment of relapsed urothelial bladder cancer with vinflunine: real-world evidence by the Hellenic Genitourinary Cancer Group.
abstract: Relapsed urothelial cancer represents an unmet medical need. Vinflunine is a third-generation antimicrotubuline inhibitor and is currently the only approved drug for second-line treatment across the European Union. We conducted a retrospective analysis assessing the efficacy and safety of vinflunine in 71 Greek patients with relapsed urothelial cancer who were treated between 2005 and 2014. An overall 84% of our patients received vinflunine as second-line treatment, 77% had a performance status of Eastern Cooperative Oncology Group scale 0 or 1, and 30% had liver metastasis at the time of vinflunine administration. A median of four cycles of vinflunine were administered (range 1-16). The most common reported adverse events were constipation, fatigue, and anemia. Median progression-free survival was 6.2 months (95% confidence interval: 4.4-8.8) and overall survival was 11.9 months (95% confidence interval: 7.4-21). Two patients (3%) achieved a complete remission, seven a partial remission (10%), and 22 (31%) had stable disease according to an intention-to-treat analysis. Hemoglobin level less than 10 g/dl and Eastern Cooperative Oncology Group performance status greater than 1 were independent adverse prognostic factors. Stratification according to the Bellmunt risk model was also associated with progression-free survival and overall survival in our population. Vinflunine appears to be a safe and effective treatment modality for relapsed urothelial cancer. More effective therapies and more accurate prognostic algorithms should be sought.
authors.affiliation: aSecond Oncology Department, MITERA Hospital, Maroussi bDepartment of Clinical Therapeutics, Medical School cSecond University Urological Clinic, Sismanoglio General Hospital dFirst University Urological Clinic, Laiko General Hospital, University of Athens, Athens eOncology University Clinic, General Hospital of Thessaloniki Papageorgiou fThird Oncology Clinic, Theagenio Cancer Hospital of Thessaloniki, Thessaloniki gOncology University Clinic, Patras University Hospital, Patras hOncology Unit, Venizeleio General Hospital, Heraklion, Greece.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Pistamaltzian
authors.forename: Kimon
authors.initials: K
authors.lastname: Tzannis
authors.forename: Vassiliki
authors.initials: V
authors.lastname: Pissanidou
authors.forename: Stavros
authors.initials: S
authors.lastname: Peroukidis
authors.forename: Georgia
authors.initials: G
authors.lastname: Milaki
authors.forename: Vasilis
authors.initials: V
authors.lastname: Karavasilis
authors.forename: Iraklis
authors.initials: I
authors.lastname: Mitsogiannis
authors.forename: Ioannis
authors.initials: I
authors.lastname: Varkarakis
authors.forename: Athanasios
authors.initials: A
authors.lastname: Papatsoris
authors.forename: Athanasios
authors.initials: A
authors.lastname: Dellis
authors.forename: Ioannis
authors.initials: I
authors.lastname: Adamakis
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Stravodimos
authors.forename: Dimitra
authors.initials: D
authors.lastname: Molyva
authors.forename: Ilias
authors.initials: I
authors.lastname: Athanasiadis
authors.forename: Nikos
authors.initials: N
authors.lastname: Androulakis
authors.forename: Charalambos
authors.initials: C
authors.lastname: Andreadis
authors.forename: Charalambos
authors.initials: C
authors.lastname: Kalofonos
authors.forename: Dionisios
authors.initials: D
authors.lastname: Mitropoulos
authors.forename: Charalambos
authors.initials: C
authors.lastname: Deliveliotis
authors.forename: Constantinos
authors.initials: C
authors.lastname: Constantinides
authors.forename: Meletios A
authors.initials: MA
authors.lastname: Dimopoulos
authors.forename: Aristotelis
authors.initials: A
authors.lastname: Bamias
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D012189:Retrospective Studies; D016019:Survival Analysis; D050257:Tubulin Modulators / Q000627:therapeutic use*; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy* / Q000473:pathology; D019459:Urothelium / Q000473:pathology*; D014747:Vinblastine / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D000970:Antineoplastic Agents; D050257:Tubulin Modulators; C111217:vinflunine; D014747:Vinblastine