Abstract
This is a single arm prospective phase II study conducted to assess the efficacy of fractionated weekly cisplatin-based neoadjuvant
chemotherapy in patients with muscle-invasive bladder cancer (MIBC) who are unfit for the standard 21-days chemotherapy
regimen due to impaired renal function. Twenty-five patients were recruited between February 2015 and July 2017. Inclusion criteria
were; age ≥18 years old, histopathologically-proven urothelial bladder cancer, stage T2-T4a, calculated glomerular filtration rate
(GFR) of 40-60 ml/min, no metastasis and with adequate organ function. Chemotherapy given was cisplatin (35 mg/m2 d1, d8, and
q21) plus gemcitabine (1,000 mg/m2 d1, d8, and q21) for three cycles followed by local therapy. Median age was 63 years (Mean±SD;
60.76 ±1.67 years). Most patients (21/25; 84%) were males. Almost half of the patients (13/25; 52%) had T3.Treatment was well-tolerated.
All patients completed the scheduled 3 Cycles. 3 (12%) patients developed complete response, 10 (40%) partial response,
6 (24%) stable disease, while 6 (24%) developed progression. Median survival was 23 months (95% CI; 18.1-27.89). Fifteen (60%)
patients underwent surgery, while 5 (20%) patients underwent bladder preservation. Four (16%) patients were shifted to palliative
care and 1(4%) patient declined any further treatment. In conclusion, fractionated weekly cispaltin-gemcitabine neoadjuvant
chemotherapy in MIBC patients with impaired renal function is feasible and safe with good clinical response. Further larger studies
are warranted.
Research Department
Research Journal
Cientific Clinical Oncology Journal
Research Member
Research Publisher
cientific group
Research Rank
1
Research Vol
Volume 1 Issue 3
Research Website
www.cientificgroup.com
Research Year
2019
Research_Pages
2-7
Research Abstract