Piotr J. Wysocki: Final results of the POUT trial support the use of adjuvant chemotherapy in upper tract urothelial cancer

Piotr J. Wysocki, Professor of Medicine and Head of Department of Oncology at Jagiellonian University Hospital in Poland, shared on LinkedIn:

“The final results of the POUT trial have been published online in J Clin Oncol by Biscombe K et al. In this seminal study, 261 muscle-invasive or node-positive disease upper tract urothelial cancer (UTUC) patients were randomized to platinum-based adjuvant chemotherapy or surveillance.

The treatment was initiated within 90 days after surgery. In the interventional arm, patients received 4 cycles of adjuvant gemcitabine+cisplatin combination or, in the case of eGFR<30-49 ml/min – gemcitabine+carboplatin combination.

After a median follow-up of 65 months, the 5-year DFS was significantly improved in the adjuvant chemotherapy arm compared to surveillance (62% v. 45% – HR for DFS = 0.55; 95%CI 0.38-0,80). The 5-year OS was 66% v. 57% – HR for OS = 0.68; 95%CI 0.46-1.00, p=0.049)

The OS was not the primary endpoint but the results of this strongly support the use of adjuvant chemotherapy in UTUC patients, especially if cisplatin+gemcitabine combination is used. In a subgroup analysis of overall survival in the cisplatin+gemcitabine subgroup, the HR for OS was 0.57 (95%CI 0.33-0.97), whereas for carboplatine+gemcitabine combination, the HR for OS was 0.87 (95%CI 0.50-1.53).”

Source: Piotr J. Wysocki/LinkedIn