Triplet chemotherapy with paclitaxel, gemcitabine, and cisplatin as second-line therapy for advanced urothelial carcinoma
Open Access
- 1 January 2013
- journal article
- Published by Scientific Research Publishing, Inc. in Modern Chemotherapy
- Vol. 02 (01), 1-7
- https://doi.org/10.4236/mc.2013.21001
Abstract
Background: Methotrexate, vinblastine, doxorubicin, and cisplatin regimen, and gemcitabine and cisplatin regimen are widely used for advanced or metastatic urothelial carcinomas (UCs). However, a standard treatment for patients who fail these firstline chemotherapies is unavailable. We examined the efficacy and safety of secondline paclitaxel, gemcitabine, and cisplatin (PCG) chemotherapy in Japanese patients. Methods: Between 2004 and 2010, 25 patients with metastatic UCs who failed to respond to platinumbased regimens were treated with PCG. They received intravenous paclitaxel (60 mg/m2) and gemcitabine (1000 mg/m2) on days 1 and 8, and cisplatin (70 mg/m2) on day 2 of every 21 day course. We retrospectively collected patients’ clinical and pathological data and evaluated adverse effects and survivals. Results: Patients underwent 95 PCG cycles in all (average, 3.8 cycles per patient). One patient (4%) achieved complete response, 5 (20%) showed partial response, 8 (42%) had disease stabilization, and 5 (26%) had disease progression. Median overall survival was 8.5 months. Neutropenia and thrombocytopenia of grade ≥ 3 were observed in 68% and 56% of patients, respectively. No treatment related death occurred. Multivariate analysis revealed that hemoglobin levels 1.73 m2) were significant risk factors for overall survival. Conclusion: PCG chemotherapy in the secondline setting potentially contributed to good prognosis in selected patients with relatively significant but tolerable toxicity.Keywords
This publication has 13 references indexed in Scilit:
- Impact of C‐reactive protein kinetics on survival of patients with advanced urothelial carcinoma treated by second‐line chemotherapy with gemcitabine, etoposide and cisplatinBJU International, 2012
- Prognostic Factors in Patients With Advanced Transitional Cell Carcinoma of the Urothelial Tract Experiencing Treatment Failure With Platinum-Containing RegimensJournal of Clinical Oncology, 2010
- Phase III Trial of Vinflunine Plus Best Supportive Care Compared With Best Supportive Care Alone After a Platinum-Containing Regimen in Patients With Advanced Transitional Cell Carcinoma of the Urothelial TractJournal of Clinical Oncology, 2009
- Revised Equations for Estimated GFR From Serum Creatinine in JapanAmerican Journal of Kidney Diseases, 2009
- Gemcitabine and paclitaxel chemotherapy for advanced urothelial carcinoma in patients who have received prior cisplatin-based chemotherapyInternational Journal of Clinical Oncology, 2008
- Preliminary report of multimodal treatment with ifosfamide, 5-fluorouracil, etoposide and cisplatin (IFEP chemotherapy) against metastatic adenocarcinoma of the urachusInternational Journal of Urology, 2008
- A phase II study of vinflunine in bladder cancer patients progressing after first-line platinum-containing regimenBritish Journal of Cancer, 2006
- Randomised phase II trial of gemcitabine and paclitaxel second-line chemotherapy in patients with transitional cell carcinoma (AUO Trial AB 20/99)International Journal of Clinical Practice, 2005
- Long-Term Survival Results of a Randomized Trial Comparing Gemcitabine Plus Cisplatin, With Methotrexate, Vinblastine, Doxorubicin, Plus Cisplatin in Patients With Bladder CancerJournal of Clinical Oncology, 2005
- Pretreatment prognostic factors for survival in patients with advanced urothelial tumors treated in a phase I/II trial with paclitaxel, cisplatin, and gemcitabineCancer, 2002