Case Report | FH-Deficient Uterine Leiomyomas: Pathological Insights into a Rare Tumor

Area of Science:

• Oncology
• Urothelial Carcinoma Treatment
• Chemotherapy Efficacy

Background:

• Cisplatin-based chemotherapy is standard for advanced urothelial carcinoma.
• Many patients are ineligible for cisplatin due to age, renal issues, or poor performance status.
• Gemcitabine-carboplatin (GCa) is a common alternative, but its efficacy versus gemcitabine-cisplatin (GC) is unclear in real-world settings.

Purpose of the Study:

• To compare the real-world efficacy and safety of gemcitabine-cisplatin (GC) versus gemcitabine-carboplatin (GCa) in patients with advanced urothelial carcinoma.
• To evaluate progression-free survival (PFS), overall survival (OS), objective response rate (ORR), and treatment-related toxicities.

Main Methods:

• Retrospective analysis of 100 advanced urothelial carcinoma patients treated with GC (n=60) or GCa (n=40).
• Primary endpoints: PFS and OS.
• Secondary endpoints: ORR, disease control rate (DCR), and adverse events.
• Kaplan-Meier methods were used for survival analysis.

Main Results:

• Median PFS was significantly longer with GC (7.6 months) compared to GCa (5.4 months) (p=0.03).
• Median OS was also significantly longer with GC (13.8 months) versus GCa (10.1 months) (p=0.04).
• Higher rates of grade 3/4 renal toxicity were observed in the GC group (18%) compared to the GCa group (6%) (p=0.02).

Conclusions:

• Gemcitabine-cisplatin (GC) demonstrates superior efficacy in PFS and OS for advanced urothelial carcinoma.
• The improved efficacy of GC comes with a higher risk of renal toxicity.
• Gemcitabine-carboplatin (GCa) is a reasonable alternative chemotherapy regimen for patients who cannot receive cisplatin.