Callihan Eryn B, Kuna Elizabeth Molina, Eule Corbin J, Kessler Elizabeth R, Flaig Thomas W
University of Colorado Cancer Center Anschutz Medical Campus, Aurora, CO, USA.
Division of Medical Oncology, University of Colorado School of Medicine, Aurora, CO, USA.
Bladder Cancer. 2025 Jan 31;11(1):23523735241310388. doi: 10.1177/23523735241310388. eCollection 2025 Jan-Mar.
The practice patterns and efficacy of ddMVAC administered with split-dose cisplatin for patients with muscle-invasive bladder cancer (MIBC) remains largely undefined.
To characterize the application and overall survival (OS) in patients with MIBC receiving conventional ddMVAC versus split-dosed ddMVAC and to examine the predictive variables in those receiving split-dosed cisplatin.
Using data from the CancerLinQ Discovery database, we identified 626 patients with bladder cancer between 2000-2023 with receipt of ddMVAC. The primary outcome was OS by receipt of split-dose versus conventional ddMVAC. A secondary outcome of interest assessed predictors of receipt of split-dose ddMVAC. Use of split-dose versus conventional ddMVAC was compared using chi-square tests. Univariate and multivariable OS were estimated using Cox proportional hazards models. Predictors of receipt of split dose versus conventional ddMVAC were estimated using logistic regression models.
Most patients with MIBC are treated with standard dose ddMVAC. In multivariate analysis, no statistically significant difference in OS was observed between split-dose and conventional ddMVAC (HR 1.3, CI 0.78-2.18, p = 0.316). We demonstrate a notable decline in the use of split-dose cisplatin over time. Baseline GFR and performance status were not predictors of split-dosing in this cohort.
Most patients with MIBC received conventional ddMVAC with decreasing frequency of split-dose cisplatin use over time. We did not observe a difference in OS between patients with MIBC who received standard versus split-dose cisplatin.
对于肌肉浸润性膀胱癌（MIBC）患者，采用分剂量顺铂给药的剂量密集型甲氨蝶呤、长春碱、阿霉素和顺铂（ddMVAC）方案的治疗模式和疗效在很大程度上仍不明确。
描述接受传统ddMVAC方案与分剂量ddMVAC方案的MIBC患者的应用情况和总生存期（OS），并研究接受分剂量顺铂治疗患者的预测变量。
利用CancerLinQ Discovery数据库的数据，我们确定了2000年至2023年间626例接受ddMVAC治疗的膀胱癌患者。主要结局是接受分剂量与传统ddMVAC方案的OS。一个感兴趣的次要结局评估了接受分剂量ddMVAC方案的预测因素。使用卡方检验比较分剂量与传统ddMVAC方案的使用情况。使用Cox比例风险模型估计单变量和多变量OS。使用逻辑回归模型估计接受分剂量与传统ddMVAC方案的预测因素。
大多数MIBC患者接受标准剂量的ddMVAC治疗。在多变量分析中，分剂量与传统ddMVAC方案在OS方面未观察到统计学上的显著差异（风险比1.3，可信区间0.78 - 2.18，p = 0.316）。我们证明随着时间推移，分剂量顺铂的使用显著减少。在该队列中，基线肾小球滤过率（GFR）和体能状态不是分剂量给药的预测因素。
大多数MIBC患者接受传统ddMVAC方案，且随着时间推移分剂量顺铂的使用频率降低。我们未观察到接受标准剂量与分剂量顺铂治疗的MIBC患者在OS方面存在差异。
