Trastuzumab (Herceptin) in metastatic transitional cell carcinoma of the urinary tract: report on six patients.

Abstract

OBJECTIVE:

To report our preliminary experience with trastuzumab (Herceptin) in the management of metastatic transitional cell carcinoma of the urinary tract.

PATIENTS AND METHODS:

From november 2001 to august 2002, six patients received trastuzumab for metastatic transitional cell carcinoma of the bladder (n=5) or renal pelvic cancer (n=1). Trastuzumab was administered as a first-line therapy in 2 patients, a second-line therapy in 3, and a third-line therapy in 1. Each patient received a weekly intravenous administration of trastuzumab (initial dose of 4 mg/kg, followed by 2mg/kg for other courses). A total of 6 courses was given. In 4 patients, trastuzumab was administered in association with paclitaxel (175 mg/m2) and carboplatin (area under the curve of 6). One patient received the same combination of trastuzumab and paclitaxel, but without carboplatin. The remaining patient received only trastuzumab.

RESULTS:

The trastuzumab-based regimen achieved partial regression of metastases in all patients. Initial regression of metastases varied between 30% and 80%. The therapy was well tolerated. Treatment-related toxicity was moderate in all patients, except for one who experienced transient grade 4 neutropenia. Five patients died from cancer. The interval between trastuzumab initiation and patient death ranged from 8 to 22 months. The remaining patient was still alive 28 months after trastuzumab initiation.

CONCLUSIONS:

Our preliminary data suggest that trastuzumab-based therapy may be safe and effective in metastatic transitional cell carcinoma of the urinary tract. Prospective trials are needed to further investigate this therapeutic option.

• Authors: Michaël Peyromaure, Florian Scotté, Delphine Amsellem-Ouazana, Annick Vieillefond, Stéphane Oudard, Philippe Beuzeboc
• Journal: European urology (Eur Urol) Vol. 48 Issue 5 Pg. 771-5; discussion 775-8 (Nov 2005) ISSN: 0302-2838 [Print] Switzerland
• PMID: 16126330 (Publication Type: Clinical Trial, Journal Article)

Chemical References

• Antibodies, Monoclonal
• Antibodies, Monoclonal, Humanized
• Antineoplastic Agents
• Carboplatin
• Receptor, ErbB-2
• Trastuzumab
• Paclitaxel

Topics

• Aged
• Antibodies, Monoclonal (therapeutic use)
• Antibodies, Monoclonal, Humanized
• Antineoplastic Agents (therapeutic use)
• Carboplatin (therapeutic use)
• Carcinoma, Transitional Cell (drug therapy, metabolism, pathology)
• Drug Therapy, Combination
• Humans
• Middle Aged
• Neoplasm Metastasis
• Paclitaxel (therapeutic use)
• Pilot Projects
• Receptor, ErbB-2 (genetics, metabolism)
• Retrospective Studies
• Trastuzumab
• Treatment Outcome
• Urologic Neoplasms (drug therapy, metabolism, pathology)