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Combination of gemcitabine and carboplatin as first line treatment in elderly patients or those unfit for cisplatin-based chemotherapy with advanced transitional cell carcinoma of the urinary tract

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Abstract

Purpose

Although cisplatin-based chemotherapy is the standard of care for advanced transitional cell carcinoma, tolerability is a challenging issue in unfit patients. This study was conducted to evaluate the efficacy, toxicity, and tolerability of the combination of gemcitabine and carboplatin in unfit patients with advanced transitional cell carcinoma.

Methods

Thirty-one patients who had advanced transitional cell carcinoma and one of the following clinical features were evaluated: Eastern Cooperative Oncology Group performance status equal or greater than 2, age older the 75 years or estimated glomerular filtration rate less than 60 ml/min. The patients were treated with carboplatin and gemcitabine delivered every 4 weeks.

Results

Of the 31 patients, 71 % had an estimated glomerular filtration rate of less than 60 ml/min, and the remaining patients were treated by this protocol due to poor performance status or age older than 75. The median age of the patients was 74 years old. A total of 162 cycles of treatment were delivered to the patients. The overall response rate was 45.1 %. After the median follow-up of 15 months, the median progression-free survival time was 9.4 months (95 % CI 7.3–11.4) and overall survival time was 20 months (95 % CI 14.9–25.0). Grades 3 and 4 anemia, thrombocytopenia, and neutropenia were observed in 22.6, 6.45, and 6.45 % of patients, respectively. There was no treatment-related mortality in our patient series.

Conclusion

The combination of gemcitabine and carboplatin is effective in elderly patients with advanced transitional cell carcinoma or those unfit for cisplatin-based chemotherapy, with manageable toxicity.

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Authors and Affiliations

  1. Division of Hematology-Oncology, Department of Medicine, Korea University Anam Hospital, Korea University College of Medicine, 126-1 Anam-dong 5-ga, Seongbuk-gu, Seoul, 136-705, South Korea

    Joo Hee Park, Soon Wook Lee, Hye Sook Kim, Seung Tae Kim, In Keun Choi, Sang Cheul Oh, Jae Hong Seo, Yeul Hong Kim, Jun Suk Kim & Kyong Hwa Park

  2. Department of Urology, Korea University School of Medicine, Korea University Robotic Urologic Surgery Center, Korea University Hospital, Seoul, 136-705, Korea

    Sung Gu Kang, Young Hwii Ko, Seok Ho Kang & Jun Cheon

  3. Department of Radiology, Korea University Medical Center, Seoul, Korea

    Deuk Jae Sung

  4. Department of Radiation Oncology, Korea University Medical Center, Seoul, Korea

    Young Je Park

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  1. Joo Hee Park
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Correspondence to Kyong Hwa Park.

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Park, J.H., Lee, S.W., Kim, H.S. et al. Combination of gemcitabine and carboplatin as first line treatment in elderly patients or those unfit for cisplatin-based chemotherapy with advanced transitional cell carcinoma of the urinary tract. Cancer Chemother Pharmacol 71, 1033–1039 (2013). https://doi.org/10.1007/s00280-013-2098-9

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  • DOI: https://doi.org/10.1007/s00280-013-2098-9

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