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Treatment patterns and clinical outcomes of chemotherapy treatment in patients with muscle-invasive or metastatic bladder cancer in the Netherlands.
- Source :
-
Scientific reports [Sci Rep] 2020 Sep 25; Vol. 10 (1), pp. 15822. Date of Electronic Publication: 2020 Sep 25. - Publication Year :
- 2020
-
Abstract
- This retrospective study was performed to evaluate real-world oncological outcomes of patients treated with chemo-based therapy for muscle-invasive or metastatic bladder cancer (MIBC/mBC) and compare results to data from RCTs and other cohorts. Among 1578 patients diagnosed, 470 (30%) had MIBC/mBC. Median overall survival (mOS) for RC alone (47 months), first-line (13 months) and second-line (7 months) chemotherapy, and chemotherapy for recurrent disease (8 months) were similar to literature. Treatment with neoadjuvant and induction chemotherapy (NAIC) was only utilized in 9% of patients, and often in patients with poor disease status, resulting in a lower mOS compared to literature (35 and 20 months, respectively). Patients treated with chemotherapy had many adversities to treatment, with only 50%, 13%, 18% and 7% of patients in NAIC, first-line, salvage after RC, and second-line setting completing the full pre-planned chemotherapy treatment. Real-world data shows NAIC before RC is underutilized. Adversities during chemotherapy treatment are frequent, with many patients requiring dose reduction or early treatment termination, resulting in poor treatment response. Although treatment efficacy between RCTs and real-world patients is quite similar, there are large differences in baseline characteristics and treatment patterns. Possibly, results from retrospective studies on real-world data can deliver missing evidence on efficacy of chemotherapy treatment on older and 'unfit' patients.
- Subjects :
- Aged
Aged, 80 and over
Female
Follow-Up Studies
Humans
Male
Middle Aged
Muscle Neoplasms drug therapy
Muscle Neoplasms secondary
Neoplasm Invasiveness
Neoplasm Metastasis
Netherlands
Retrospective Studies
Survival Rate
Treatment Outcome
Urinary Bladder Neoplasms drug therapy
Urinary Bladder Neoplasms pathology
Antineoplastic Combined Chemotherapy Protocols therapeutic use
Muscle Neoplasms mortality
Neoadjuvant Therapy mortality
Urinary Bladder Neoplasms mortality
Subjects
Details
- Language :
- English
- ISSN :
- 2045-2322
- Volume :
- 10
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Scientific reports
- Publication Type :
- Academic Journal
- Accession number :
- 32978455
- Full Text :
- https://doi.org/10.1038/s41598-020-72820-y