Cisplatin-based chemotherapy boosts survival in muscle-invasive bladder cancer

The researchers retrieved 10 published or unpublished RCTs (n=1,183) from the online databases of Medline, Embase, CENTRAL, and ClinicalTrials.gov, as well as from conference proceedings. Over a median follow-up of 6.0 years across all trials, 610 deaths occurred and revealed a significant protective effect of adjuvant cisplatin-based chemotherapy (hazard ratio [HR], 0.82, 95 percent confidence interval [CI], 0.70–0.96; p=0.02).

In absolute terms, such a risk estimate led to a 6-percent improvement in overall survival at 5 years. Using a random-effects model did not alter the principal finding (HR, 0.82, 95 percent CI, 0.70–0.96; p=0.02).

Moreover, pooled analysis of nine RCTs (n=1,075), in which 472 recurrence events and 143 deaths were recorded, showed that cisplatin chemotherapy likewise yielded significant benefit for recurrence-free survival (HR, 0.71, 95 percent CI, 0.60–0.83; p<0.001). The same was true for locoregional recurrence-free survival, according to a synthesis of six RCTs (n=884; HR, 0.68, 95 percent CI, 0.55–0.85; p<0.001).

Meta-analysis of six RCTs (n=884), describing 425 metastasis or death events, likewise showed that cisplatin-based adjuvant chemotherapy led to significant improvements in metastasis-free survival (HR, 0.79, 95 percent CI, 0.65–0.95; p=0.02).

“We looked at the effect of cisplatin-based chemotherapy on outcomes in participants with muscle-invasive bladder cancer. We gathered this information from eligible RCTs,” the researchers said. “We demonstrated that cisplatin-based chemotherapy is a valid option for improving outcomes of muscle-invasive bladder cancer.”