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   <dc:title>Epicure: a European epidemiological study of patients with an advanced or metastatic Urothelial Carcinoma (UC) having progressed to a platinum-based chemotherapy</dc:title>
   <dc:creator>Houédé, N.</dc:creator>
   <dc:creator>Locker, G.</dc:creator>
   <dc:creator>Lucas, C.</dc:creator>
   <dc:creator>Soto Parra, H.</dc:creator>
   <dc:creator>Basso, U.</dc:creator>
   <dc:creator>Spaeth, D.</dc:creator>
   <dc:creator>Tambaro, R.</dc:creator>
   <dc:creator>Basterretxea, L.</dc:creator>
   <dc:creator>Morelli, F.</dc:creator>
   <dc:creator>Theodore, C.</dc:creator>
   <dc:creator>Lusuardi, L.</dc:creator>
   <dc:creator>Lainez, N.</dc:creator>
   <dc:creator>Guillot, A.</dc:creator>
   <dc:creator>Tonini, G.</dc:creator>
   <dc:creator>Bielle, J.</dc:creator>
   <dc:creator>García del Muro Solans, Xavier</dc:creator>
   <dc:subject>Càncer de bufeta</dc:subject>
   <dc:subject>Cisplatí</dc:subject>
   <dc:subject>Epidemiologia</dc:subject>
   <dc:subject>Bladder cancer</dc:subject>
   <dc:subject>Cisplatin</dc:subject>
   <dc:subject>Epidemiology</dc:subject>
   <dcterms:abstract>Background: Platinum-based systemic chemotherapy is considered the backbone for management of advanced urothelial carcinomas. However there is a lack of real world data on the use of such chemotherapy regimens, on patient profiles and on management after treatment failure. Methods: Fifty-one randomly selected physicians from 4 European countries registered 218 consecutive patients in progression or relapse following a first platinum-based chemotherapy. Patient characteristics, tumor history and treatment regimens, as well as the considerations of physicians on the management of urothelial carcinoma were recorded. Results: A systemic platinum-based regimen had been administered as the initial chemotherapy in 216 patients: 15 in the neoadjuvant setting, 61 in adjuvant therapy conditions, 137 in first-line advanced setting and 3 in other conditions. Of these patients, 76 (35 %) were initially considered as cisplatin-unfit, mainly because of renal impairment (52 patients). After platinum failure, renal impairment was observed in 44 % of patients, ECOG Performance Status ≥ 2 in 17 %, hemoglobinemia &lt; 10 g/dL in 16 %, hepatic metastases in 13 %. 80 % of these patients received further anticancer therapy. Immediately after failure of adjuvant/neoadjuvant chemotherapy, most subsequent anticancer treatments were chemotherapy doublets (35/58), whereas after therapy failure in the advanced setting most patients receiving further anticancer drugs were treated with a single agent (80/114). After first progression to chemotherapy, treatment decisions were mainly driven by Performance Status and prior response to chemotherapy (>30 % patients). The most frequent all-settings second anticancer therapy regimen was vinflunine (70 % of single-agent and 42 % of all subsequent treatments), the main reasons evoked by physicians (>1 out of 4) being survival benefit, safety and phase III evidence. Conclusion: In this daily practice experience, a majority of patients with urothelial carcinoma previously treated with a platinum-based therapy received a second chemotherapy regimen, most often a single agent after an initial chemotherapy in the advanced setting and preferably a cytotoxic combination after a neoadjuvant or adjuvant chemotherapy. Performance Status and prior response to chemotherapy were the main drivers of further treatment decisions.</dcterms:abstract>
   <dcterms:issued>2022-03-04T18:14:34Z</dcterms:issued>
   <dcterms:issued>2022-03-04T18:14:34Z</dcterms:issued>
   <dcterms:issued>2016-09-23</dcterms:issued>
   <dcterms:issued>2022-03-04T18:14:35Z</dcterms:issued>
   <dc:type>info:eu-repo/semantics/article</dc:type>
   <dc:type>info:eu-repo/semantics/publishedVersion</dc:type>
   <dc:relation>Reproducció del document publicat a: https://doi.org/10.1186/s12885-016-2782-3</dc:relation>
   <dc:relation>BMC Cancer, 2016, vol. 16, num. 1, p. 752-752</dc:relation>
   <dc:relation>https://doi.org/10.1186/s12885-016-2782-3</dc:relation>
   <dc:rights>cc-by (c) Houédé, N. et al., 2016</dc:rights>
   <dc:rights>https://creativecommons.org/licenses/by/4.0/</dc:rights>
   <dc:rights>info:eu-repo/semantics/openAccess</dc:rights>
   <dc:publisher>BioMed Central</dc:publisher>
   <dc:source>Articles publicats en revistes (Ciències Clíniques)</dc:source>
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