Urothelial cancer: VTE risk higher with gemcitabine/cisplatin

  • Ramos JD & al.
  • BJU Int
  • 22 Jan 2019

  • curated by Deepa Koli
  • Univadis Clinical Summaries
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Takeaway

  • 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 design

  • Study of 5594 patients with urothelial bladder cancer from the Surveillance, Epidemiology, and End Results (SEER)-Medicare database who received chemotherapy.
  • Funding: None disclosed.

Key results

  • 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.>

Limitations

  • Retrospective design.

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