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  1. Article ; Online: Oncological Outcomes of Neoadjuvant Gemcitabine plus Carboplatin versus Gemcitabine plus Cisplatin in Locally Advanced Bladder Cancer: A Retrospective Analysis.

    Mofid, Bahram / Razzaghdoust, Abolfazl / Ghajari, Mahdi / Basiri, Abbas / Fattahi, Mohammad-Reza / Houshyari, Mohammad / Jafari, Anya / Taghizadeh-Hesary, Farzad

    Urology journal

    2022  Volume 19, Issue 5, Page(s) 371–378

    Abstract: Purpose: Cisplatin-based neoadjuvant chemotherapy (NAC) is the standard of care in non-metastatic muscle-invasive bladder cancer (MIBC). There are limited data regarding the alternative choices for cisplatin-ineligible patients. This study has ... ...

    Abstract Purpose: Cisplatin-based neoadjuvant chemotherapy (NAC) is the standard of care in non-metastatic muscle-invasive bladder cancer (MIBC). There are limited data regarding the alternative choices for cisplatin-ineligible patients. This study has investigated the oncological outcomes of gemcitabine plus cisplatin (Gem/Cis) and gemcitabine plus carboplatin (Gem/Carbo) in this setting.
    Materials and methods: One hundred forty consecutive patients with MIBC (cT2-T4a) receiving neoadjuvant Gem/Cis or Gem/Carbo before chemoradiation (CRT) or radical cystectomy (RC) were retrospectively evaluated between April 2009 and April 2019. Patients with ECOG performance status 2, creatinine clearance < 60 mL/min, hydronephrosis, ejection fraction < 50%, or single kidney received Gem/Carbo. The complete clinical response (cCR) and overall survival (OS) of NAC regimens were compared. Prognostic significance was assessed with Cox proportional hazards model.
    Results: In total, 79 patients (56.4%) received Gem/Cis. The cCR was not significantly different between Gem/Cis and Gem/Carbo regimens (38.7% vs. 36.2%, P = .771). After NAC, 79 patients (56.4%) received CRT, and other cases underwent RC. After a median follow-up of 43 months, patients in the Gem/Cis group had significantly better OS than Gem/Carbo (median OS: 41.0 vs. 26.0 months, P = .008). Multivariable Cox proportional hazards models identified cT4a stage (95% confidence interval [95% CI]: 1.001-4.85, hazard ratio [HR] = 2.08, P = .03) and cCR (95% CI: 0.26-0.99, HR = 0.51, P = .04) as the only independent prognostic factors of OS, and ruled out the type of NAC regimen.
    Conclusion: The choice of NAC (between Gem/Cis and Gem/Carbo) is not the predictor of survival and both regimens had similar cCR.
    MeSH term(s) Humans ; Urinary Bladder Neoplasms/drug therapy ; Urinary Bladder Neoplasms/pathology ; Neoadjuvant Therapy ; Cisplatin ; Retrospective Studies ; Carboplatin/therapeutic use ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Cystectomy
    Chemical Substances Cisplatin (Q20Q21Q62J) ; gemcitabine (B76N6SBZ8R) ; Carboplatin (BG3F62OND5)
    Language English
    Publishing date 2022-11-08
    Publishing country Iran
    Document type Journal Article
    ZDB-ID 2251940-3
    ISSN 1735-546X ; 1735-1308
    ISSN (online) 1735-546X
    ISSN 1735-1308
    DOI 10.22037/uj.v19i.6841
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Association of immunohistochemical markers of tumor subtype with response to neoadjuvant chemotherapy and survival in patients with muscle-invasive bladder cancer.

    Razzaghdoust, Abolfazl / Ghajari, Mahdi / Basiri, Abbas / Torbati, Peyman Mohammadi / Jafari, Anya / Fattahi, Mohammad Reza / Salahi, Maryam / Mofid, Bahram

    Investigative and clinical urology

    2021  Volume 62, Issue 3, Page(s) 274–281

    Abstract: Purpose: A readily accessible biomarker to identify which patients with bladder cancer are more likely to respond to neoadjuvant chemotherapy (NAC) could help clinicians avoid unnecessary chemotherapy and prevent its subsequent complications in some ... ...

    Abstract Purpose: A readily accessible biomarker to identify which patients with bladder cancer are more likely to respond to neoadjuvant chemotherapy (NAC) could help clinicians avoid unnecessary chemotherapy and prevent its subsequent complications in some patients. The primary objective of this study was to investigate the association of immunohistochemical markers of tumor subtype with response to NAC and survival of patients with muscle-invasive bladder cancer (MIBC).
    Materials and methods: MIBC patients treated with NAC were retrospectively included. The tissue microarrays were assembled from transurethral resection of bladder tumor (TURBT) specimens and immunohistochemistry (IHC) was performed. The association of independent variables, including IHC markers, and clinical covariates with clinical complete response to NAC and with overall survival was assessed by using logistic regression and Cox proportional hazard regression analysis, respectively. Kaplan-Meier curves were plotted for different IHC-based tumor subtypes.
    Results: Data from 140 MIBC patients treated with NAC were retrospectively reviewed. A total of 63 patients with available TURBT specimens were eligible to be included in the analysis. Our results showed that the IHC signature of KRT5/6(+)/KRT20(-), as a combined marker of basal subtype, was the only covariate significantly associated with complete response to NAC (p=0.037). Moreover, we found no statistically significant differences in overall survival between different IHC-based subtypes (p=0.721).
    Conclusions: The IHC expression of KRT5/6 and KRT20, as a readily accessible combined marker, may help us to identify the patients most likely to benefit from chemotherapy. The clinical utility of this marker needs to be established in larger prospective studies.
    MeSH term(s) Aged ; Antineoplastic Agents/therapeutic use ; Biomarkers/metabolism ; Chemotherapy, Adjuvant ; Cystectomy ; Female ; Humans ; Immunohistochemistry ; Keratin-20/metabolism ; Keratin-5/metabolism ; Keratin-6/metabolism ; Logistic Models ; Male ; Middle Aged ; Neoadjuvant Therapy ; Neoplasm Invasiveness ; Proportional Hazards Models ; Retrospective Studies ; Survival Rate ; Urinary Bladder Neoplasms/metabolism ; Urinary Bladder Neoplasms/mortality ; Urinary Bladder Neoplasms/therapy
    Chemical Substances Antineoplastic Agents ; Biomarkers ; KRT20 protein, human ; KRT5 protein, human ; KRT6A protein, human ; Keratin-20 ; Keratin-5 ; Keratin-6
    Language English
    Publishing date 2021-05-04
    Publishing country Korea (South)
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2923014-7
    ISSN 2466-054X ; 2466-0493
    ISSN (online) 2466-054X
    ISSN 2466-0493
    DOI 10.4111/icu.20200425
    Database MEDical Literature Analysis and Retrieval System OnLINE

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