Combination of gemcitabine and paclitaxel is a favorable option for patients with advanced or metastatic urothelial carcinoma previously treated with cisplatin-based chemotherapy.

Abstract

OBJECTIVE:

To evaluate the efficacy and toxicity of a gemcitabine and paclitaxel regimen for patients with advanced urothelial carcinoma who had previously been treated with methotrexate, vinblastine, doxorubicin and cisplatin chemotherapy, and to determine the prognostic factors for survival in second-line chemotherapy.

METHODS:

From June 2005 to April 2010, 24 eligible patients who had previously been treated with methotrexate, vinblastine, doxorubicin and cisplatin chemotherapy were enrolled in this study. Patients received paclitaxel 200 mg/m(2) on Day 1 and gemcitabine 1000 mg/m(2) on Days 1, 8 and 15. The gemcitabine and paclitaxel regimen was repeated every 3 weeks. Patients were evaluated every two cycles by imaging study.

RESULTS:

Ten of 24 patients (42%) had major response to the gemcitabine and paclitaxel regimen, including 2 patients (8%) who had complete response. Median survival time and median progression-free survival were 12.4 and 6.1 months, respectively. Good performance status and major response to first-line methotrexate, vinblastine, doxorubicin and cisplatin treatment were significant predictors of overall survival and progression-free survival. Grade 3 or 4 neutropenia occurred in 16 patients (67%), but there were no severe infections. There were no treatment-related deaths.

CONCLUSIONS:

Gemcitabine and paclitaxel chemotherapy had favorable benefit and safety profiles, and the regimen is recommended as a potential second-line chemotherapy for advanced or metastatic urothelial carcinoma previously treated with methotrexate, vinblastine, doxorubicin and cisplatin chemotherapy.

• Authors: Masaomi Ikeda, Kazumasa Matsumoto, Ken-Ichi Tabata, Satoru Minamida, Tetsuo Fujita, Takefumi Satoh, Masatsugu Iwamura, Shiro Baba
• Journal: Japanese journal of clinical oncology (Jpn J Clin Oncol) Vol. 41 Issue 10 Pg. 1214-20 (Oct 2011) ISSN: 1465-3621 [Electronic] England
• PMID: 21903707 (Publication Type: Clinical Trial, Journal Article)

Chemical References

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

Topics

• Adult
• Aged
• Antineoplastic Combined Chemotherapy Protocols (adverse effects, therapeutic use)
• Carcinoma, Transitional Cell (drug therapy)
• Cisplatin (administration & dosage)
• Deoxycytidine (administration & dosage, adverse effects, analogs & derivatives)
• Disease-Free Survival
• Doxorubicin (administration & dosage)
• Female
• Humans
• Male
• Methotrexate (administration & dosage)
• Middle Aged
• Paclitaxel (administration & dosage, adverse effects)
• Survival Analysis
• Urinary Bladder Neoplasms (drug therapy)
• Urologic Neoplasms (drug therapy)
• Vinblastine (administration & dosage)
• Gemcitabine