Second-line Chemotherapy for Advanced Bladder Cancer: Taxanes Versus Vinflunine
Aim: Second-line chemotherapy in advanced urothelial carcinoma (UC) remains a significant clinical challenge, with limited high-level evidence guiding regimen selection. Vinflunine is the only agent approved by the European Medicines Agency for this setting, while taxanes are widely used off-label b...
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| Format: | Article |
| Language: | English |
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Galenos Publishing House
2025-08-01
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| Series: | Acta Haematologica Oncologica Turcica |
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| Online Access: | https://www.actaoncologicaturcica.com/articles/second-line-chemotherapy-for-advanced-bladder-cancer-taxanes-versus-vinflunine/doi/ahot.galenos.2025.2025-7-2 |
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| author | Bilgin Demir Ali Aytaç Gökhan Çolak Onur Yazdan Balçık Ömer Acar |
| author_facet | Bilgin Demir Ali Aytaç Gökhan Çolak Onur Yazdan Balçık Ömer Acar |
| author_sort | Bilgin Demir |
| collection | DOAJ |
| description | Aim: Second-line chemotherapy in advanced urothelial carcinoma (UC) remains a significant clinical challenge, with limited high-level evidence guiding regimen selection. Vinflunine is the only agent approved by the European Medicines Agency for this setting, while taxanes are widely used off-label based on phase 2 data.
Methods: We conducted a retrospective analysis of patients with metastatic bladder cancer treated at Aydın Adnan Menderes University between 2013 and 2022. Eligible patients had received at least three months of second-line chemotherapy with either vinflunine or taxane-based regimens (docetaxel or paclitaxel). Progression-free survival (PFS), overall survival (OS), objective response rate (ORR), and adverse events were compared between groups.
Results: Among 38 patients receiving second-line therapy, 25 (65.8%) were treated with taxanes and 13 (34.2%) with vinflunine. Median PFS was significantly longer in the taxane group (4.9 vs. 2.2 months; p=0.001). Median OS favored taxanes numerically (13.2 vs. 4.33 months) but did not reach statistical significance (p=0.068). ORR was higher in the taxane group (52% vs. 23.1%), but the difference was not statistically significant (p=0.87). Adverse event profiles were consistent with known toxicities.
Conclusion: This single-center retrospective study suggests that taxane-based regimens may offer superior PFS compared to vinflunine in the second-line treatment of advanced UC, despite the lack of statistically significant OS benefit. Given limitations in access to immunotherapy and targeted agents, cytotoxic chemotherapy remains essential, underscoring the need for further prospective trials to define optimal second-line strategies. |
| format | Article |
| id | doaj-art-4cab9ed6a9164eb3bc10d9ebbafb49f8 |
| institution | Kabale University |
| issn | 3061-9947 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Galenos Publishing House |
| record_format | Article |
| series | Acta Haematologica Oncologica Turcica |
| spelling | doaj-art-4cab9ed6a9164eb3bc10d9ebbafb49f82025-08-20T03:43:50ZengGalenos Publishing HouseActa Haematologica Oncologica Turcica3061-99472025-08-0158215015510.4274/ahot.galenos.2025.2025-7-2Second-line Chemotherapy for Advanced Bladder Cancer: Taxanes Versus VinflunineBilgin Demir0https://orcid.org/0000-0003-4380-9419Ali Aytaç1https://orcid.org/0000-0001-9753-8517Gökhan Çolak2https://orcid.org/0000-0002-3802-461XOnur Yazdan Balçık3https://orcid.org/0000-0002-3386-2075Ömer Acar4https://orcid.org/0000-0003-4408-1976Aydın Adnan Menderes University Faculty of Medicine, Department of Medical Oncology, Aydın, TürkiyeMehmet Akif İnan Training and Research Hospital, Clinic of Medical Oncology, Şanlıurfa, TürkiyeAydın Adnan Menderes University Faculty of Medicine, Department of Medical Oncology, Aydın, TürkiyeAlanya Alaaddin Keykubat University Faculty of Medicine, Department of Medical Oncology, Antalya, TürkiyeMardin Training and Research Hospital, Clinic of Medical Oncology, Mardin, TürkiyeAim: Second-line chemotherapy in advanced urothelial carcinoma (UC) remains a significant clinical challenge, with limited high-level evidence guiding regimen selection. Vinflunine is the only agent approved by the European Medicines Agency for this setting, while taxanes are widely used off-label based on phase 2 data. Methods: We conducted a retrospective analysis of patients with metastatic bladder cancer treated at Aydın Adnan Menderes University between 2013 and 2022. Eligible patients had received at least three months of second-line chemotherapy with either vinflunine or taxane-based regimens (docetaxel or paclitaxel). Progression-free survival (PFS), overall survival (OS), objective response rate (ORR), and adverse events were compared between groups. Results: Among 38 patients receiving second-line therapy, 25 (65.8%) were treated with taxanes and 13 (34.2%) with vinflunine. Median PFS was significantly longer in the taxane group (4.9 vs. 2.2 months; p=0.001). Median OS favored taxanes numerically (13.2 vs. 4.33 months) but did not reach statistical significance (p=0.068). ORR was higher in the taxane group (52% vs. 23.1%), but the difference was not statistically significant (p=0.87). Adverse event profiles were consistent with known toxicities. Conclusion: This single-center retrospective study suggests that taxane-based regimens may offer superior PFS compared to vinflunine in the second-line treatment of advanced UC, despite the lack of statistically significant OS benefit. Given limitations in access to immunotherapy and targeted agents, cytotoxic chemotherapy remains essential, underscoring the need for further prospective trials to define optimal second-line strategies.https://www.actaoncologicaturcica.com/articles/second-line-chemotherapy-for-advanced-bladder-cancer-taxanes-versus-vinflunine/doi/ahot.galenos.2025.2025-7-2urothelial carcinomasecond-line chemotherapytaxanesvinflunine |
| spellingShingle | Bilgin Demir Ali Aytaç Gökhan Çolak Onur Yazdan Balçık Ömer Acar Second-line Chemotherapy for Advanced Bladder Cancer: Taxanes Versus Vinflunine Acta Haematologica Oncologica Turcica urothelial carcinoma second-line chemotherapy taxanes vinflunine |
| title | Second-line Chemotherapy for Advanced Bladder Cancer: Taxanes Versus Vinflunine |
| title_full | Second-line Chemotherapy for Advanced Bladder Cancer: Taxanes Versus Vinflunine |
| title_fullStr | Second-line Chemotherapy for Advanced Bladder Cancer: Taxanes Versus Vinflunine |
| title_full_unstemmed | Second-line Chemotherapy for Advanced Bladder Cancer: Taxanes Versus Vinflunine |
| title_short | Second-line Chemotherapy for Advanced Bladder Cancer: Taxanes Versus Vinflunine |
| title_sort | second line chemotherapy for advanced bladder cancer taxanes versus vinflunine |
| topic | urothelial carcinoma second-line chemotherapy taxanes vinflunine |
| url | https://www.actaoncologicaturcica.com/articles/second-line-chemotherapy-for-advanced-bladder-cancer-taxanes-versus-vinflunine/doi/ahot.galenos.2025.2025-7-2 |
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