Treatment of relapsed urothelial bladder cancer with vinflunine: real-world evidence by the Hellenic Genitourinary Cancer Group.

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.

• Authors: Nikolaos Pistamaltzian, Kimon Tzannis, Vassiliki Pissanidou, Stavros Peroukidis, Georgia Milaki, Vasilis Karavasilis, Iraklis Mitsogiannis, Ioannis Varkarakis, Athanasios Papatsoris, Athanasios Dellis, Ioannis Adamakis, Konstantinos Stravodimos, Dimitra Molyva, Ilias Athanasiadis, Nikos Androulakis, Charalambos Andreadis, Charalambos Kalofonos, Dionisios Mitropoulos, Charalambos Deliveliotis, Constantinos Constantinides, Meletios A Dimopoulos, Aristotelis Bamias
• Journal: Anti-cancer drugs (Anticancer Drugs) Vol. 27 Issue 1 Pg. 48-53 (Jan 2016) ISSN: 1473-5741 [Electronic] England
• PMID: 26421462 (Publication Type: Journal Article)

Chemical References

• Antineoplastic Agents
• Tubulin Modulators
• vinflunine
• Vinblastine

Topics

• Aged
• Antineoplastic Agents (therapeutic use)
• Female
• Humans
• Male
• Middle Aged
• Neoplasm Recurrence, Local
• Retrospective Studies
• Survival Analysis
• Tubulin Modulators (therapeutic use)
• Urinary Bladder Neoplasms (drug therapy, pathology)
• Urothelium (pathology)
• Vinblastine (analogs & derivatives, therapeutic use)