Methotrexate, vinblastine, doxorubicin and cisplatin combination regimen as salvage chemotherapy for patients with advanced or metastatic transitional cell carcinoma after failure of gemcitabine and cisplatin chemotherapy.

Abstract

We investigated the safety and efficacy of a methotrexate, vinblastine, doxorubicin and cisplatin (M-VAC) combination regimen as second-line chemotherapy for patients with advanced or metastatic transitional cell carcinoma who failed first-line gemcitabine and cisplatin (GC) chemotherapy. Thirty patients who had progressed or relapsed after GC chemotherapy as first-line treatment were enrolled in this study. The major toxicities were neutropaenia and thrombocytopaenia. A grade 3 or 4 neutropaenia occurred in 19 (63.3%) and a grade 3 or 4 thrombocytopaenia developed in nine patients (30.0%). There were no life-threatening complications during the study. The overall response was 30%. A complete response was achieved in two patients (6.7%) and a partial response in seven (23.3%). The overall disease control rate was 50%. Seven out of 16 patients who had responded previously to GC responded to M-VAC, while 2 out of 14 who had not responded to GC responded to M-VAC. The median response duration was 3.9 months and the median progression-free survival was 5.3 months. The median overall survival was 10.9 months. M-VAC showed encouraging efficacy and reversible toxicities in patients who had progressed after GC chemotherapy and, especially, M-VAC appears to be a reasonable option as a sequential treatment regimen in patients who responded previously to GC chemotherapy.

• Authors: K S Han, J Y Joung, T S Kim, I G Jeong, H K Seo, J Chung, K H Lee
• Journal: British journal of cancer (Br J Cancer) Vol. 98 Issue 1 Pg. 86-90 (Jan 15 2008) ISSN: 0007-0920 [Print] England
• PMID: 18087289 (Publication Type: Journal Article)

Chemical References

• Deoxycytidine
• Vinblastine
• Doxorubicin
• Cisplatin
• Methotrexate
• Gemcitabine

Topics

• Adult
• Aged
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Carcinoma, Transitional Cell (drug therapy, secondary)
• Cisplatin (administration & dosage, therapeutic use)
• Deoxycytidine (administration & dosage, analogs & derivatives)
• Doxorubicin (therapeutic use)
• Drug Resistance, Neoplasm
• Female
• Humans
• Kidney Neoplasms (drug therapy, pathology)
• Male
• Methotrexate (therapeutic use)
• Middle Aged
• Salvage Therapy
• Survival Rate
• Treatment Failure
• Treatment Outcome
• Vinblastine (therapeutic use)
• Gemcitabine