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Use of Gemcitabine plus Carboplatin is Associated with Poor Outcomes in Urothelial Carcinoma Patients with Chronic Kidney Disease Stage 4-5

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Abstract
Abstract
Purpose: This study aimed to investigate the clinical outcomes with gemcitabine-carboplatin (GCb), the standard treatment for patients with advanced urothelial carcinoma (UC) who are ineligible for cisplatin-based regimens, in advanced UC patients with a glomerular filtration rate (GFR) < 30 mL/min.

Materials and methods: A retrospective cohort study involving GCb-treated advanced UC patients with GFR < 60 mL/min (n=89) was performed. Clinical outcomes were compared between subgroups with GFR < 30 mL/min and GFR ≥ 30 mL/min but < 60 mL/min.

Results: Most baseline characteristics were comparable between the two subgroups. Patients with GFR < 30 mL/min had a significantly lower objective response rate (12.5%) compared to those with higher GFR levels (56.7%) (p=0.004). The number of GCb cycles was significantly lower in patients with GFR < 30 mL/min (median 2 cycles) than in those with higher GFR levels (median 6 cycles) (p=0.002). Compared to those with GFR ≥ 30 mL/min but < 60 mL/min, patients with GFR < 30 mL/min showed significantly worse progression-free survival (PFS) and overall survival (OS) (p < 0.001 for both). Further stratification of patient subgroups according to their GFR (i.e., GFR ≥ 45 mL/min but < 60 mL/min vs. GFR ≥ 30 mL/min but < 45 mL/min vs. GFR < 30 mL/min) revealed significantly different PFS and OS (p < 0.001 for both).

Conclusion: The use of GCb is discouraged in advanced UC patients with GFR < 30 mL/min. Alternative therapeutic approaches with better efficacy are warranted for these patients.

Keywords: Gemcitabine plus carboplatin; Glomerular filtration rate; Objective response rate; Urothelial carcinoma.
Author(s)
김좌훈김형돈박인근윤신교이재련임현수정혜현
Issued Date
2021
Type
Article
Keyword
Gemcitabine plus carboplatinGlomerular filtration rateObjective response rateUrothelial carcinoma.
DOI
10.4143/crt.2021.091
URI
https://oak.ulsan.ac.kr/handle/2021.oak/8466
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_nrf_kci_oai_kci_go_kr_ARTI_9870966&amp;context=PC&amp;vid=ULSAN&amp;lang=ko_KR&amp;search_scope=default_scope&amp;adaptor=primo_central_multiple_fe&amp;tab=default_tab&amp;query=any,contains,Use%20of%20Gemcitabine%20plus%20Carboplatin%20is%20Associated%20with%20Poor%20Outcomes%20in%20Urothelial%20Carcinoma%20Patients%20with%20Chronic%20Kidney%20Disease%20Stage%204-5&amp;offset=0&amp;pcAvailability=true
Publisher
CANCER RESEARCH AND TREATMENT
Location
대한민국
Language
영어
ISSN
1598-2998
Citation Volume
53
Citation Number
4
Citation Start Page
1166
Citation End Page
1173
Appears in Collections:
Medicine > Medicine
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