According to the lead author, Dr. Francesco Atzori, progress in developing new effective drugs in bladder cancer has been stagnant in the last decades.
"In patients who recur or who are refractory to first-line therapy, response rates and outcomes are grim, and to date, no second-line therapy has been clearly established," he explained.
The authors state that while upfront chemotherapy (CT) confers over 50% response rate, progression free survival and overall survival rates are still dismal. While vinflunine is approved by the EMA for progressive bladder cancer after platinum-based therapy, the US FDA has no approved agents.
In the course of the study, the researchers retrospectively queried all patients receiving 2nd and 3rd line regimens in Italy in the period between 2001 and 2013. The inclusion criteria included failure of one or two prior CT regimens for metastatic disease and no exclusion of specific salvage regiments, including targeted agents. Distribution of treatments and outcome parameters were the primary endpoints.
The authors identified a total of 160 eligible pts across 8 centers nationwide. Median age was 67 years (IQR 39-82), most frequent sites of disease at relapse were: nodes 71% (nodes only 43, 26.9%); lung 30%, bone 26% and liver 20%. Bellmunt Score available in 147 out of 160 patients was 0, 1, 2 and 3 in 63 (43%), 59 (40%), 20 (14%) and 5 (3%) patients respectively.
Regiments used as upfront CT were cisplatin-gemcitabine in 65 patients (41%), carboplatin-G in 50 patients (31%), MVAC in 25 patients (16%), other combination CT in 5 patients (3%) and single-agent CT in 15 patients (9%).
In 2nd line 42 patients (26%) received paclitaxel, 40 (25%) vinflunine, 21 (13%) pazopanib, 10 (6%) MVAC, 47 (29%) other drugs alone or combined.
75 out of 160 patients (47%) received a 3rd line regimen: 19 (25%) paclitaxel, 15 (20%) pazopanib, 11 (15%) MVAC, 30 patients (40%) miscellaneous. Median time-to-relapse to 1st line was 2 months. Overall response rate in 2nd line was 21% (32 out of 160 patients) and 21% in 3rd line (16 out of 75 patients); median progression-free survival was 2,8 and 2 months in 2nd and 3rd line respectively, median overall survival was 16 months and 20 months, in 2nd and 3rd lines respectively. Patients treated with paclitaxel and vinflunine in 2nd line showed a median progression free survival of 2.7 and 3.3 months while overall survival was 13.5 and 13.4 months respectively.
The results of this study will be presented at the European Multidisciplinary Meeting on Urological Cancers, in Marceille, France, on 15-17 November 2013.
Reference: Francesco Atzori et al, Efficacy of second and third-line chemotherapy in patients with advanced transitional-cell carcinoma: Results of a national multicentre pooled analysis, Abstract O3, 5th EMUC.
Evgenia Starkova | EurekAlert!
Study relating to materials testing Detecting damages in non-magnetic steel through magnetism
23.07.2018 | Technische Universität Kaiserslautern
Innovative genetic tests for children with developmental disorders and epilepsy
11.07.2018 | Christian-Albrechts-Universität zu Kiel
Scientists develop first tool to use machine learning methods to compute flow around interactively designable 3D objects. Tool will be presented at this year’s prestigious SIGGRAPH conference.
When engineers or designers want to test the aerodynamic properties of the newly designed shape of a car, airplane, or other object, they would normally model...
Researchers from TU Graz and their industry partners have unveiled a world first: the prototype of a robot-controlled, high-speed combined charging system (CCS) for electric vehicles that enables series charging of cars in various parking positions.
Global demand for electric vehicles is forecast to rise sharply: by 2025, the number of new vehicle registrations is expected to reach 25 million per year....
Proteins must be folded correctly to fulfill their molecular functions in cells. Molecular assistants called chaperones help proteins exploit their inbuilt folding potential and reach the correct three-dimensional structure. Researchers at the Max Planck Institute of Biochemistry (MPIB) have demonstrated that actin, the most abundant protein in higher developed cells, does not have the inbuilt potential to fold and instead requires special assistance to fold into its active state. The chaperone TRiC uses a previously undescribed mechanism to perform actin folding. The study was recently published in the journal Cell.
Actin is the most abundant protein in highly developed cells and has diverse functions in processes like cell stabilization, cell division and muscle...
Scientists have discovered that the electrical resistance of a copper-oxide compound depends on the magnetic field in a very unusual way -- a finding that could help direct the search for materials that can perfectly conduct electricity at room temperatur
What happens when really powerful magnets--capable of producing magnetic fields nearly two million times stronger than Earth's--are applied to materials that...
The quality of materials often depends on the manufacturing process. In casting and welding, for example, the rate at which melts solidify and the resulting microstructure of the alloy is important. With metallic foams as well, it depends on exactly how the foaming process takes place. To understand these processes fully requires fast sensing capability. The fastest 3D tomographic images to date have now been achieved at the BESSY II X-ray source operated by the Helmholtz-Zentrum Berlin.
Dr. Francisco Garcia-Moreno and his team have designed a turntable that rotates ultra-stably about its axis at a constant rotational speed. This really depends...
08.08.2018 | Event News
27.07.2018 | Event News
25.07.2018 | Event News
14.08.2018 | Information Technology
14.08.2018 | Life Sciences
14.08.2018 | Life Sciences