Archivos espanoles de urologia · 2026
Real-World Comparative Effectiveness of Lobaplatin Versus Epirubicin and Gemcitabine for Post-TURBT Intravesical Therapy in Non-Muscle-Invasive Bladder Cancer.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Han Sujun, Li Xu, Ma Limin, Hu Zhiquan, Jia Zhankui, Wu Minhong, Xing Nianzeng
Аннотация
OBJECTIVE: To evaluate the effectiveness and safety of lobaplatin versus epirubicin or gemcitabine for intravesical instillation in post-therapy following transurethral resection of bladder tumour (TURBT) non-muscle-invasive bladder cancer (NMIBC) patients in the absence of randomized evidence.
METHODS: This retrospective study analysed clinical data from 522 NMIBC patients who received postoperative intravesical therapy with lobaplatin (n = 121), epirubicin (n = 128), or gemcitabine (n = 273) at tertiary hospitals in China between 2019 to 2022. Key tumour-specific factors, including T stage (Ta, T1), tumour grade, were collected from medical records. Given the non-randomized nature of real-world data, propensity score matching (PSM) was applied to reduce baseline imbalance. For the lobaplatin vs. epirubicin comparison, PSM included age, sex, smoking history, tumour location, surgical history, surgical method, and need for secondary resection. For the lobaplatin vs. gemcitabine comparison, PSM included sex, tumour location, surgical method, and requirement for re-resection. The study compared 1-year and two-year recurrence-free survival (RFS), progression to muscle-invasive bladder cancer (MIBC), and treatment related dose adjustments.
RESULTS: After PSM, 79 patients were in each of the lobaplatin and epirubicin groups, and 119 patients were in each of the lobaplatin and gemcitabine groups. Lobaplatin and epirubicin showed comparable 1-year (100% vs. 98.73%, p = 0.32) and 2-year RFS rates (98.67% vs. 97.45%, p = 0.57). In the lobaplatin versus gemcitabine comparison, the 1-year RFS rates were 97.48% and 90.69%, respectively (p = 0.026), and the 2-year RFS rates were 95.75% and 88.98%, respectively (p = 0.047). Dose adjustments were less frequent with lobaplatin than with epirubicin (31.65% vs. 51.90%, p = 0.010) and comparable between lobaplatin and gemcitabine (24.37% vs. 24.37%, p > 0.999).
CONCLUSIONS: In this real-world retrospective cohort, lobaplatin instillation showed comparable effectiveness to epirubicin and differences in outcomes compared with gemcitabine in post-TURBT NMIBC, with fewer dose adjustments compared to epirubicin.
METHODS: This retrospective study analysed clinical data from 522 NMIBC patients who received postoperative intravesical therapy with lobaplatin (n = 121), epirubicin (n = 128), or gemcitabine (n = 273) at tertiary hospitals in China between 2019 to 2022. Key tumour-specific factors, including T stage (Ta, T1), tumour grade, were collected from medical records. Given the non-randomized nature of real-world data, propensity score matching (PSM) was applied to reduce baseline imbalance. For the lobaplatin vs. epirubicin comparison, PSM included age, sex, smoking history, tumour location, surgical history, surgical method, and need for secondary resection. For the lobaplatin vs. gemcitabine comparison, PSM included sex, tumour location, surgical method, and requirement for re-resection. The study compared 1-year and two-year recurrence-free survival (RFS), progression to muscle-invasive bladder cancer (MIBC), and treatment related dose adjustments.
RESULTS: After PSM, 79 patients were in each of the lobaplatin and epirubicin groups, and 119 patients were in each of the lobaplatin and gemcitabine groups. Lobaplatin and epirubicin showed comparable 1-year (100% vs. 98.73%, p = 0.32) and 2-year RFS rates (98.67% vs. 97.45%, p = 0.57). In the lobaplatin versus gemcitabine comparison, the 1-year RFS rates were 97.48% and 90.69%, respectively (p = 0.026), and the 2-year RFS rates were 95.75% and 88.98%, respectively (p = 0.047). Dose adjustments were less frequent with lobaplatin than with epirubicin (31.65% vs. 51.90%, p = 0.010) and comparable between lobaplatin and gemcitabine (24.37% vs. 24.37%, p > 0.999).
CONCLUSIONS: In this real-world retrospective cohort, lobaplatin instillation showed comparable effectiveness to epirubicin and differences in outcomes compared with gemcitabine in post-TURBT NMIBC, with fewer dose adjustments compared to epirubicin.