Treatment Patterns and Outcomes by Age in Metastatic Urinary Tract Cancer: A Retrospective Tertiary Cancer Center...

Area of Science:

• Oncology
• Geriatric Medicine
• Cancer Treatment

Background:

• Metastatic urinary tract cancer (mUTC) presents unique treatment challenges in older adults due to comorbidities.
• Age-related factors can influence treatment tolerance and outcomes in advanced cancers.

Purpose of the Study:

• To compare the clinical courses of younger and older (≥70 years) adults with mUTC receiving first-line (1L) systemic therapy.
• To evaluate treatment tolerability and survival outcomes in different age groups.

Main Methods:

• Retrospective analysis of 212 patients (103 older vs. 109 younger) with mUTC treated at a tertiary cancer center.
• Comparison of baseline characteristics, 1L treatments, subsequent therapies, clinical trial participation, and survival outcomes.

Main Results:

• Older patients had lower baseline hemoglobin, were more often cisplatin-ineligible, and received more immunotherapy (52% vs. 36%).
• Older patients received fewer subsequent treatment lines (0 vs. 1) and had lower clinical trial participation (18% vs. 30%).
• Despite requiring more chemotherapy dose adjustments (53.4% vs. 23%) and fewer cycles (median 4 vs. 5), older patients experienced similar overall survival (OS) (11.2 vs. 14 months) and severe toxicity rates compared to younger patients.

Conclusions:

• Select older adults with mUTC can be safely treated with immunotherapy and risk-adjusted chemotherapy regimens.
• These tailored approaches offer tangible survival benefits for older patients with metastatic urinary tract cancer.