Effects of Chemotherapy-Induced Neutropenia on Overall Survival in Patients With Unresectable or Metastatic Urothelial Carcinoma to Gemcitabine Plus Cisplatin Combination Chemotherapy

Abstract

Background: Chemotherapy-induced neutropenia (CIN) is an important dose-limiting toxicity of chemotherapy. However, evidence suggests that the occurrence of CIN may be predictive of treatment outcome. Indeed, studies have revealed that the onset of CIN is associated with a good chemotherapeutic response. Objective: The purpose of this study was to investigate the association between the onset of CIN and overall survival in patients with unresectable or metastatic urothelial carcinoma (UC) who received a combination regimen of gemcitabine and cisplatin (GC). Methods: Medical records from 56 patients with unresectable or metastatic UC who were treated with a combination GC regimen between December 2005 and May 2016 were retrospectively analyzed to investigate the association between CIN development and survival. Results: The median duration of survival was 521 days (95% CI = 147-193 days) for patients with severe CIN and 287 days for patients without CIN. Additional multivariate analysis revealed that both the presence of severe CIN (hazard ratio [HR] = 0.399; 95% CI = 0.180-0.880, P = 0.023) and baseline hemoglobin (HR = 2.167; 95% CI = 1.170-4.014, P = 0.014) represented independent prognostic factors for the survival of patients with unresectable or metastatic UC receiving GC treatment. Conclusion and Relevance: CIN onset was associated with longer survival in patients receiving GC therapy for unresectable or metastatic UC, suggesting that neutropenia monitoring during GC chemotherapy may be predictive of treatment efficacy.

Chemotherapy-induced neutropenia as a prognostic factor in patients with extensive-stage small cell lung cancer

“…[3][4][5] Chemotherapy-induced neutropenia (CIN) is a signi cant dose-limiting toxicity for many cytotoxic anticancer drugs, but an interesting association between the occurrence of CIN and a favorable clinical outcome has been reported in several solid tumors. [6][7][8][9][10] In lung cancer, post-hoc analyses of clinical trials for non-small cell lung cancer have also reported that the occurrence of CIN contributes signi cantly to prolonged survival. [11] , [12] However, because of the limited number of SCLC cases, few studies have been conducted thus far to evaluate the prognostic role of CIN in patients with ED-SCLC.…”

Relevance of pharmacogenetic polymorphisms with response to docetaxel, cisplatin, and 5-fluorouracil chemotherapy in esophageal cancer

“…Chemotherapy-induced neutropenia is an important dose-limiting toxicity of anticancer agents, and an association between chemotherapy-induced neutropenia and good clinical response has been reported in several solid tumor types [8][9][10][11][12][13][14]. It has also been reported that the occurrence of neoadjuvant chemotherapy-induced severe neutropenia is correlated with a high histological response in patients with esophageal squamous cell carcinoma [15].…”