Single-agent Taxane Versus Taxane-containing Combination Chemotherapy as Salvage Therapy for Advanced Urothelial Carcinoma

摘要: Abstract Background Single-agent taxanes are commonly used as salvage systemic therapy for patients with advanced urothelial carcinoma (UC). Objective To study the impact of combination chemotherapy delivering a taxane plus other chemotherapeutic agents compared single-agent therapy. Design, setting, and participants Individual patient-level data from phase 2 trials were used. Interventions Trials evaluating either single (paclitaxel or docetaxel) (taxane one agent more) following prior platinum-based Outcome measurements statistical analysis Information regarding known major baseline prognostic factors was required: time chemotherapy, hemoglobin, performance status, albumin, liver metastasis status. Cox proportional hazards regression to evaluate association versus overall survival (OS). Results limitations Data available eight including 370 patients; two ( n =109) evaluated docetaxel =72) cremophor-free paclitaxel =37), six =261) gemcitabine–paclitaxel (two trials, =99 =24), paclitaxel–cyclophosphamide =32), paclitaxel–ifosfamide–nedaplatin =45), docetaxel–ifosfamide–cisplatin =26), paclitaxel–epirubicin =35). On multivariable after adjustment factors, independently significantly associated improved OS (hazard ratio: 0.60; 95% confidence interval, 0.45–0.82; p =0.001). The retrospective design this trial-eligible population inherent limitations. Conclusions Patients enrolled in exhibited UC. Prospective randomized required validate potential role rational tolerable regimens Patient summary This suggests that may extend selected metastatic cancer progressing chemotherapy.