Introduction and objective: Cisplatin is preferred to carboplatin when treating metastatic urothelial carcinoma of the bladder (mUCB), despite its greater toxicity. Randomised studies underpinning this have been performed in non-contemporary populations with limitations in sample sizes and analyses, affecting their validity in current clinical practice. The objective of this study is to estimate overall survival (OS) and assess the benefit of cisplatin-based regimens over carboplatin-based regimens in a contemporary cohort of patients with mUCB.
Methods: A nationwide retrospective cohort study of patients diagnosed with de novo mUCB in the Netherlands between 2016 and 2019 who underwent first-line treatment with cisplatin- or carboplatin-based chemotherapy, based on data from the Netherlands Cancer Registry. A propensity model for receiving cisplatin-based chemotherapy based on age, sex, age-adjusted Charlson Comorbidity Index, renal function, performance status, serum haemoglobin, and the presence of visceral and bone metastases was used to produce inverse probability weights (IPW) per patient. Unadjusted and IPW-adjusted Kaplan–Meier OS curves of both chemotherapy groups were compared by restricted mean survival times (RMST).
Results: Of the 1041 patients with mUCB, 359 received either cisplatin (n = 170; 47%) or carboplatin (n = 189; 53%) first line. The cisplatin group was younger, had fewer comorbidities, and had better performance status and renal function. The median OS in the cisplatin and carboplatin groups was 13.1 and 11.5 months, respectively. After IPW-adjustment, prognostic factors were balanced between the two chemotherapy groups (standardised differences <0.1) and differences in RMST were <2.0 months and not statistically significant up to 24 months.
Conclusion: After accounting for all known prognostic factors, we found no significant survival benefit for cisplatin over carboplatin as a first-line chemotherapy in mUCB.

Overall survival of patients receiving cisplatin and carboplatin for primary metastatic urothelial carcinoma of the bladder: a contemporary Dutch nationwide cohort study

For 2021, our focus remains: turning new data into your daily practice. The programme will consist of state-of-the-art lectures, case discussions and panel debates. Our faculty is a group of international & multidisciplinary experts.

We will take you on our journey to Ghent and beyond. Prior the congress, we send out case challenges, where you can compare your opinion with peers & experts. These cases will be part of the Global Congresses on Prostate & Bladder Cancer programme during the congress days (12 & 13 October for PROSCA and 14 & 15 October for BLADDR). After these days, you will be updated on prostate & bladder cancer management.