Treatment of relapsed urothelial bladder cancer with vinflunine: real-world evidence by the Hellenic Genitourinary Cancer Group. Issue 1 (January 2016)

• Record Type: Journal Article
• Authors: Pistamaltzian, Nikolaos; Tzannis, Kimon; Pissanidou, Vassiliki; Peroukidis, Stavros; Milaki, Georgia; Karavasilis, Vasilis; Mitsogiannis, Iraklis; Varkarakis, Ioannis; Papatsoris, Athanasios; Dellis, Athanasios; Adamakis, Ioannis; Stravodimos, Konstantinos; Molyva, Dimitra; Athanasiadis, Ilias; Androulakis, Nikos; Andreadis, Charalambos; Kalofonos, Charalambos; Mitropoulos, Dionisios; Deliveliotis, Charalambos; Constantinides, Constantinos; Dimopoulos, Meletios A.; Bamias, Aristotelis
• Is Part Of: Anti-cancer drugs. Volume 27:Issue 1(2016)
• Publication Date: 2016-01
• Subjects: prognostic factors -- second line therapy -- survival -- third-generation vinca alcaloid -- transitional cell carcinoma; Antineoplastic agents -- Periodicals; Cancer -- Chemotherapy -- Periodicals; Antineoplastic Agents -- therapeutic use -- Periodicals; Drug Therapy -- Periodicals; 616.994061
• DOI: 10.1097/CAD.0000000000000297
• Languages: English
• ISSNs: 0959-4973

Abstract

Abstract : Relapsed urothelial cancer represents an unmet medical need. Vinflunine is a third-generation antimicrotubuline inhibitor and is currently the only approved drug for second-line treatment across the European Union. We conducted a retrospective analysis assessing the efficacy and safety of vinflunine in 71 Greek patients with relapsed urothelial cancer who were treated between 2005 and 2014. An overall 84% of our patients received vinflunine as second-line treatment, 77% had a performance status of Eastern Cooperative Oncology Group scale 0 or 1, and 30% had liver metastasis at the time of vinflunine administration. A median of four cycles of vinflunine were administered (range 1–16). The most common reported adverse events were constipation, fatigue, and anemia. Median progression-free survival was 6.2 months (95% confidence interval: 4.4–8.8) and overall survival was 11.9 months (95% confidence interval: 7.4–21). Two patients (3%) achieved a complete remission, seven a partial remission (10%), and 22 (31%) had stable disease according to an intention-to-treat analysis. Hemoglobin level less than 10 g/dl and Eastern Cooperative Oncology Group performance status greater than 1 were independent adverse prognostic factors. Stratification according to the Bellmunt risk model was also associated with progression-free survival and overall survival in our population. Vinflunine appears to be a safe and effective treatment modality for relapsed urothelial cancer. More effective therapies and more accurate prognostic algorithms should be sought.