Oncotarget

Clinical Research Papers:

Efficacy and safety of dose-dense chemotherapy in urothelial carcinoma

Chenjing Zhu, Jiaming Liu, Jing Zhang, Qingfang Li, Qisi Lian, Jing Xu and Xuelei Ma _

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Oncotarget. 2017; 8:71117-71127. https://doi.org/10.18632/oncotarget.16759

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Abstract

Chenjing Zhu1,*, Jiaming Liu2,*, Jing Zhang3,*, Qingfang Li1, Qisi Lian4, Jing Xu3 and Xuelei Ma1

1Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China

2Department of Urology, Institute of Urology, Laboratory of Reconstructive Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China

3West China School of Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China

4West China School of Stomatology, Sichuan University, Chengdu, Sichuan, China

*These authors contributed equally to this work

Correspondence to:

Xuelei Ma, email: [email protected]

Keywords: dose-dense, urothelial carcinoma, meta-analysis

Received: August 08, 2016     Accepted: March 22, 2017     Published: March 31, 2017

ABSTRACT

We conducted a meta-analysis to assess the efficacy and safety of dose-dense chemotherapy in the treatment of patients with urothelial carcinoma. A systematic search was conducted in PubMed, Medline, Embase, Web of Science and Cochrane Collaboration's Central register of controlled trials (CENTRAL) for relevant articles. Data was obtained from 10 trials with a total of 1093 patients. The pooled pathologic complete response (pCR) was 27.8% in the ten studies with a full cohort of 684 patients who received dose-dense methotrexate, vinblastine, adriamycin and cisplatin (dd-MVAC). In the controlled trials, although the difference was not significant, the pCR rate in the dd-MVAC group has a trend of increase (odds ratio (OR) 1.52; 95% confidence interval (CI) 0.78-2.98, P = 0.22) compared with classic MVAC group. A significant improvement of overall survival (OS) (hazard ratio (HR) 0.77, 95% CI 0.61–0.97, p = 0.03) was also observed. Hematologic toxicities were the most frequent grade ≥ 3 toxicities including neutropenia/febrile neutropenia (17.5%), anemia (9.4%) and thrombocytopenia (6.1%). Compared with the classic MVAC group, dd-MVAC was associated with significantly decreased risks of all-grade adverse events (AEs) such as anemia (OR 0.457, 95% CI 0.249–0.840, p = 0.012), febrile neutropenia (OR 0.398 95% CI 0.233–0.681, p = 0.001), and neutropenia (OR 0.373, 95% CI 0.201–0.691, p = 0.002). In conclusion, dose-dense chemotherapy was effective and tolerable in patients with urothelial carcinoma, which could be considered as a reasonable therapeutic option.


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