Adjuvant Chemotherapy May Be New Standard of Care for Upper Tract Urothelial Cancer

Adjuvant gemcitabine-based chemotherapy prolongs progression-free survival (PFS) among patients with upper tract urothelial cancer (UTUC), according to research being presented at the 2018 Genitourinary Cancers Symposium in San Francisco, California.¹

For this phase 3 study of perioperative chemotherapy vs surveillance for UTUC (POUT; ClinicalTrials.gov Identifier: NCT01993979), researchers randomly assigned 345 patients with muscle-invasive or node-positive UTUC who underwent nephro-ureterectomy within the preceding 90 days to gemcitabine plus cisplatin or surveillance with subsequent chemotherapy if needed.

The median follow-up was 17.6 months at time of interim analysis. The 2-year disease-free survival (DFS) rates were 51% (95% CI, 39%-61%) and 70% (95% CI, 58%-79%) in the surveillance and chemotherapy arms, respectively. Patients treated with chemotherapy also had significantly improved PFS vs the surveillance arm (hazard ratio [HR], 0.49; 95% CI, 0.30-0.79; P = .003).

DFS events were reported in 38.2% of patients in the surveillance arm vs 23.2% in the chemotherapy arm (P = .0009). Grade 3 or worse adverse events were reported in 60% and 24% of patients in the chemotherapy and surveillance arms, respectively.

The authors concluded that “whilst follow up for [overall survival] continues, this should be considered a new standard of care in these patients.”

Read more of Cancer Therapy Advisor‘s coverage of the 2018 Genitourinary Cancers Symposium by visiting the conference page.

Reference

1. Birtle AJ, Chester JD, Jones RJ, et al. Results of POUT: a phase III randomised trial of perioperative chemotherapy versus surveillance in upper tract urothelial cancer (UTUC). Oral presentation at: 2018 Genitourinary Cancers Symposium; February 8-10, 2018; San Francisco, CA.