A consensus definition of patients with metastatic urothelial carcinoma who are unfit for cisplatin-based chemotherapy

Worldwide, more than 386 000 patients are diagnosed with urothelial carcinoma (UC) every year, and more than 150 000 will succumb to the disease.1 Although from 2003–07, the median age at time of death from UC was 78 years,2 in the past few decades, the median age for patients enrolled in phase 3 trials that assess cisplatin-based chemotherapy regimens for metastatic UC has been 64 years.3 This discrepancy, and the associated high rate of renal insufficiency and impaired functional status with advancing age,4 has resulted in a disconnect between treatment efficacy and treatment effectiveness when applied to the general population of patients with UC.