P3-6-4 - Efficacy and safety of etoposide in patients with platinum-pretreated metastatic or recurrent urothelial cancer

Abstract

Backgroud: Platinum containing regimen is the standard first line chemotherapy in patients with metastatic or recurrent urothelial cancer (UC). Although paclitaxel is one of the second line treatment options, its efficacy is not sufficient.Methods: To evaluate etoposide in patients with UC pretreated with platinum agent, we reviewed the patient records in Japanese Nagoya Daiichi Red Cross hospital and Fujita Health University hospital. Etoposide is administrated as 100mg/m2 injection in day1 to 3 every 3 weeks until documented disease progression, unacceptable toxicities, or patient refusal.Results: From October 2010 to September 2014, 24 patients received etoposide therapy. Two patients were excluded from the analysis due to the histology without UC. The patient characteristics were as follows: median age, 72.5 years (range, 55 to 82); men/women, 12/10; performance status, 0/1/2, 9/12/1; primary site, bladder/ureter/pelvis, 13/7/2; primary site, unresected/resected, 9/13; estimated glomerular filtrating rate (calculated by Cockcroft-Gault formula), median 45.5ml/min (range, 25 to 83); metastatic site, lymph node/lung/liver/bone, 14/4/6/4; and number of previous chemotherapeutic regimen, 1/2 or more, 16/6. At a median follow-up time of 9.8 months (range 2.7 to 44.7 months), response rate, disease control rate, 6-months progression-free survival (PFS) rate, median PFS, and median overall survival were 11%, 50%, 34% [95% confidential interval(CI), 16 to 54 %], 4.3 months [95% CI, 2.3 to 12.3 months], and 9.4 months (95% CI, 6.4 to 22.2 months), respectively. The common grade 3/4 toxicities were neutropenia (68%), anemia (9%), febrile neutropenia (14%), appetite loss (5%), and arterial thrombosis (5%). Treatment related death was not observed.Conclusion: Etoposide was well tolerated for patients with platinum-pretreated UC. The efficacy was almost equal to previous reports of paclitaxel monotherapy. Future evaluation in prospective study is warranted. Backgroud: Platinum containing regimen is the standard first line chemotherapy in patients with metastatic or recurrent urothelial cancer (UC). Although paclitaxel is one of the second line treatment options, its efficacy is not sufficient. Methods: To evaluate etoposide in patients with UC pretreated with platinum agent, we reviewed the patient records in Japanese Nagoya Daiichi Red Cross hospital and Fujita Health University hospital. Etoposide is administrated as 100mg/m2 injection in day1 to 3 every 3 weeks until documented disease progression, unacceptable toxicities, or patient refusal. Results: From October 2010 to September 2014, 24 patients received etoposide therapy. Two patients were excluded from the analysis due to the histology without UC. The patient characteristics were as follows: median age, 72.5 years (range, 55 to 82); men/women, 12/10; performance status, 0/1/2, 9/12/1; primary site, bladder/ureter/pelvis, 13/7/2; primary site, unresected/resected, 9/13; estimated glomerular filtrating rate (calculated by Cockcroft-Gault formula), median 45.5ml/min (range, 25 to 83); metastatic site, lymph node/lung/liver/bone, 14/4/6/4; and number of previous chemotherapeutic regimen, 1/2 or more, 16/6. At a median follow-up time of 9.8 months (range 2.7 to 44.7 months), response rate, disease control rate, 6-months progression-free survival (PFS) rate, median PFS, and median overall survival were 11%, 50%, 34% [95% confidential interval(CI), 16 to 54 %], 4.3 months [95% CI, 2.3 to 12.3 months], and 9.4 months (95% CI, 6.4 to 22.2 months), respectively. The common grade 3/4 toxicities were neutropenia (68%), anemia (9%), febrile neutropenia (14%), appetite loss (5%), and arterial thrombosis (5%). Treatment related death was not observed. Conclusion: Etoposide was well tolerated for patients with platinum-pretreated UC. The efficacy was almost equal to previous reports of paclitaxel monotherapy. Future evaluation in prospective study is warranted.