Effect of relative cumulative dose-intensity on survival of patients with urothelial cancer treated with M-VAC Journal Article

  


Authors: Scher, H. I.; Geller, N. L.; Curley, T.; Tao, Y.
Article Title: Effect of relative cumulative dose-intensity on survival of patients with urothelial cancer treated with M-VAC
Abstract: Purpose: To evaluate the received dose-intensity in a mature data set of patients with advanced urothelial cancer who received at least one cycle of the methotrexate (M), vinblastine (V), Adriamycin ([A], doxorubicin; Adria Laboratories, Columbus, OH), and cisplatin (C) regimen (M-VAC). Patients and Methods; Received dose-intensity was evaluated over time by summing doses over cycles for each patient, cumulating treatment times, and assuming four cycles of chemotherapy were planned. Relative cumulative dose-intensity was then calculated for individual patients at the end of each cycle. To assess a relationship with survival, relative cumulative dose-intensity was then used as a time-dependent covariate in Cox regression. Results: The median follow-up was 6 years and median survival 13.3 months, with 20 patients alive at the time of analysis. Out of a maximum of 1.0, the median relative dose-intensity for the M-VAC combination de creased from .69 to .59 from cycle 1 to cycle 4. Similarly, a decrease from .68 to .62 and from .80 to .72 was observed for A and C, respectively. The median received dose-intensity for A was 6.0 mg/m2/wk, and for C 14 mg/m2/wk. Neither the four-cycle relative cumulative dose-intensity for the M-VAC combination, nor the relative cumulative dose-intensities for A or C were found to be significant prognostic factors. Conclusion: The absence of an effect for received dose-intensity on survival may reflect the low dose-intensities of the components of the regimen actually delivered in this study. The results question whether the individual agents can be escalated sufficiently, with growth factor support, to improve significantly complete response proportions, a prerequisite for increasing the proportion of long-term survivors. & 1993 by American Society of Clinical Oncology.
Keywords: cancer survival; treatment outcome; survival analysis; retrospective studies; major clinical study; cisplatin; doxorubicin; advanced cancer; cancer combination chemotherapy; methotrexate; antineoplastic combined chemotherapy protocols; drug administration schedule; dose-response relationship, drug; vinblastine; urologic neoplasms; urogenital tract tumor; regression analysis; growth factor; mathematics; dose time effect relation; human; priority journal; article; support, u.s. gov't, p.h.s.
Journal Title: Journal of Clinical Oncology
Volume: 11
Issue: 3
ISSN: 0732-183X
Publisher: American Society of Clinical Oncology  
Date Published: 1993-03-01
Start Page: 400
End Page: 407
Language: English
DOI: 10.1200/jco.1993.11.3.400
PUBMED: 8445414
PROVIDER: scopus
DOI/URL:

https://www.scopus.com/inward/record.uri?eid=2-s2.0-0027528981&doi=10.1200%2fJCO.1993.11.3.400&partnerID=40&md5=247fd4ea2e54c983033f982ae861244a
Notes: Article -- Export Date: 1 March 2019 -- Source: Scopus
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MSK Authors
  1. Tracy B Smart-Curley
    70 Smart-Curley
  2. Howard Scher
    1130 Scher
  3. Yue Tao
    20 Tao
  4. Nancy L. Geller
    65 Geller
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