- In patients with urothelial tract cancer, gemcitabine+cisplatin is associated with greater odds of venous thromboembolism (VTE) than methotrexate/vinblastine/doxorubicin/cisplatin (MVAC) and gemcitabine+carboplatin (CarboG).
- VTE was associated with worse OS vs no-VTE.
Why this matters
- Findings suggest that for high-risk patients, gemcitabine/cisplatin regimen may not be suitable and VTE prophylaxis may be useful.
- Study of 5594 patients with urothelial bladder cancer from the Surveillance, Epidemiology, and End Results (SEER)-Medicare database who received chemotherapy.
- Funding: None disclosed.
- Within 120 days of chemotherapy initiation, the incidence of VTE was:
- 15.3% with gemcitabine+cisplatin,
- 8.7% with MVAC, and
- 12.0% with CarboG.
- Compared with gemcitabine+cisplatin, MVAC (OR, 0.60; P=.02) and CarboG (OR, 0.71; P<.01 were associated with significantly lower vte risk.>
- VTE within 120 days of chemotherapy initiation was associated with worse OS overall and for each therapy (all P<.001>
- Asian race (aOR, 0.39; 95% CI, 0.19-0.80), preoperative therapy (aOR, 0.68; P=.01), renal dysfunction (aOR, 1.47; P=.01), and VTE within the prior 6 months (aOR, 10.94; P<.001 were significant risk factors for vte.>
- Retrospective design.