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Galsky Criteria

                • Criteria was developed by                                                    Consensus criteria for patients unfit to receive

                   consensus opinion                                                                            cisplatin-based therapy

                • Developed for metastatic disease,

                   not MIBC                                                     Performance status              WHO or ECOG PS ≥2 or KPS of 60%–70%

                • Goal was to standardize trial                                 Renal function                  CrCl <60 ml/min (calculated or measured)
                   design, widely extrapolated

                                                                                Neuropathy                      CTCAE v4 grade ≥2 peripheral neuropathy
                • Excludes half of patients for

                   cisplatin, compromises outcomes
                                                                                Hearing                         CTCAE v4 grade ≥2 audiometric hearing loss

                • Incidence of nephrotoxicity is less,

                   now due to lower doses and                                   Cardiac function                New York Heart Association class III heart
                   better supportive care                                                                       failure

                           Following these criteria our patient with a CrCl of 50 ml/min would not receive NAC

                           CrCl, creatinine clearance; CTCAE, Common Terminology Criteria for Adverse Events; ECOG, Eastern Cooperative Oncology Group; KPS, Karnofsky performance status; PS, performance status ; WHO, World Health Organization.
                                                                                                                                                 Adapted from Galsky MD, et al. Lancet Oncol 2011;12(3):211-4.
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