Paclitaxel Carboplatin chemotherapy as a second-line chemotherapy for advanced platinum resistant urothelial cancer in Japanese cases.

Abstract

OBJECTIVE:

We evaluated the efficacy and toxicity of Paclitaxel Carboplatin (Pca) therapy in patients with advanced urothelial cancer and platinum based chemotherapy failure.

PATIENTS AND METHODS:

From April 2001 to September 2005, 18 patients were enrolled in this trial. The patients received methotrexate, vinblastine and doxorubicin cisplatin (M-VAC) therapy prior to Pca therapy. On day 1, Paclitaxel (175 mg/m(2), body surface) was injected followed by Carboplatin area under the curve (AUC) (5) via an external venous line and treatment was repeated on a 21-day cycle. Cases exhibiting either a response or stable disease were treated until progression of the disease was observed. All patients were examined to determine toxicity (National Cancer Institute common toxicity criteria) and QOL (EORTC QOL-C30). The survival curves were established using Kaplan-Meier graphs.

RESULTS:

The median cycle of Pca therapy was 4 cycles (range, 1-9 cycles). The overall survival response was 33% with a partial response in six patients (0 with CR, 6 with PR), stable disease in eight patients (44%) and disease progression in four patients (22%). Grade 3-4 anemia was recognized in 5 (28%), neutropenia in 9 (50%) and thrombocytopenia in 3 (22%). The QOL questionnaire scales showed no significant changes induced by Pca therapy. The progression free survival rates were 33% at 6 months, 16% at 1 year and 5.2% at 2 years. Regarding overall survival period, the 6 month, 1-year and 2-year estimates were 78%, 50% and 22%, respectively.

CONCLUSION:

Since the Pca therapy was well tolerated we consider that this treatment modality has the potential to prolong survival with a high quality of life when used as a second chemotherapy.

• Authors: Norihito Soga, Takehisa Onishi, Kiminobu Arima, Yoshiki Sugimura
• Journal: International journal of urology : official journal of the Japanese Urological Association (Int J Urol) Vol. 14 Issue 9 Pg. 828-32 (Sep 2007) ISSN: 0919-8172 [Print] Australia
• PMID: 17760750 (Publication Type: Clinical Trial, Journal Article)

Chemical References

• Antineoplastic Agents
• Carboplatin
• Paclitaxel

Topics

• Aged
• Antineoplastic Agents (administration & dosage, adverse effects, therapeutic use)
• Antineoplastic Combined Chemotherapy Protocols
• Carboplatin (administration & dosage, adverse effects, therapeutic use)
• Carcinoma, Transitional Cell (drug therapy, mortality)
• Drug Resistance, Neoplasm
• Female
• Humans
• Japan (epidemiology)
• Male
• Middle Aged
• Neoplasm Metastasis (drug therapy)
• Paclitaxel (administration & dosage, adverse effects, therapeutic use)
• Prospective Studies
• Quality of Life
• Salvage Therapy
• Treatment Outcome
• Urologic Neoplasms (drug therapy, mortality)