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Comparative Study
. 2019 May;24(5):688-690.
doi: 10.1634/theoncologist.2018-0561. Epub 2019 Feb 6.

Efficacy of Split Schedule Versus Conventional Schedule Neoadjuvant Cisplatin-Based Chemotherapy for Muscle-Invasive Bladder Cancer

Chelsea K Osterman  1 , Dilip S Babu  2 , Daniel M Geynisman  3 , Bianca Lewis  3 , Robert A Somer  4 , Arjun V Balar  5 , Matthew R Zibelman  3 , Elizabeth A Guancial  6 , Gianna Antinori  4 , Shun Yu  7 , Vivek Narayan  7 , Thomas J Guzzo  8 , Elizabeth R Plimack  3 , David J Vaughn  8 , Chunkit Fung  2 , Ronac Mamtani  9
Affiliations
Comparative Study

Efficacy of Split Schedule Versus Conventional Schedule Neoadjuvant Cisplatin-Based Chemotherapy for Muscle-Invasive Bladder Cancer

Chelsea K Osterman et al. Oncologist. 2019 May.

Abstract

Neoadjuvant cisplatin-based chemotherapy (NAC; 70 mg/m2) is standard of care for muscle-invasive bladder carcinoma (MIBC). Many patients (pts) cannot receive cisplatin because of renal impairment, and administration of cisplatin 35 mg/m2 on day 1 + 8 or 1 + 2 (i.e., split schedule) is a commonly used alternative. In this retrospective analysis, we compared complete (pT0) and partial (<pT2) pathologic response rates between split schedule (SS) and conventional schedule (CS) pts, after 1:1 matching on chemotherapy regimen, number of cycles, tumor histology, and clinical stage. Eighty matched pts were identified. pT0 rates were 17.5% (95% confidence interval [CI], 7%-33%) and 32.5% (95% CI, 19%-49%) in SS and CS cisplatin pts, respectively (p = .21), corresponding to an odds ratio for pT0 of 0.45 (95% CI, 0.16-1.31) with SS cisplatin. Split schedule cisplatin was associated with numerically but not statistically significant lower pathologic response rates relative to full dose.

Keywords: Cisplatin; Muscle‐invasive bladder cancer; Neoadjuvant chemotherapy; Nephrotoxicity.

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Conflict of interest statement

Disclosures of potential conflicts of interest may be found at the end of this article.

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References

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