Predictive ability of the geriatric 8 screening tool for treatment completion of dose-dense methotrexate, vinblastine, doxorubicin, and cisplatin therapy in patients with urothelial carcinoma.

Abstract

Background: Dose-dense methotrexate, vinblastine, doxorubicin, and cisplatin (dd-MVAC) therapy is expected to provide superior therapeutic efficacy compared to gemcitabine and cisplatin therapy as systemic chemotherapy for urothelial carcinoma. However, its high incidence of adverse events raises concerns about tolerability, particularly in older patients. This study evaluated the utility of the Geriatric 8 (G8) screening tool in patients undergoing dd-MVAC therapy and assessed its association with treatment progress.

Methods: A retrospective analysis was conducted on 65 patients with urothelial carcinoma who received dd-MVAC therapy between August 2018 and May 2023, with the goal of completing six treatment cycles. The G8 score was evaluated before treatment initiation, and its association with treatment completion and adverse events was examined.

Results: The median age of patients was 71 years (range, 43-84 years), with 65% male and 35% female. The median pretreatment G8 score was 13 (range, 7-17). Patients with a G8 score ≥14 demonstrated a significantly higher six-cycle treatment completion rate than those with a G8 score <14 (87% vs. 60%, P = 0.026). The incidence of adverse events did not differ between the groups. Furthermore, among various clinicopathological factors, the G8 score was identified as an independent predictor of six-cycle treatment completion (odds ratio: 0.17, P = 0.021), along with Eastern Cooperative Oncology Group Performance Status.

Conclusion: Pretreatment G8 scores were associated with the treatment completion rates of dd-MVAC therapy.