Gemcitabine plus carboplatin; and gemcitabine, docetaxel, and carboplatin combined chemotherapy regimens in patients with metastatic urothelial carcinoma previously treated with a platinum-based regimen: preliminary report

Background

The aim of this study was to evaluate the efficacy and safety of two combined chemotherapy regimens in the treatment of previously treated metastatic urothelial carcinoma: gemcitabine plus carboplatin (GC), and gemcitabine, docetaxel, and carboplatin (GDC).

Methods

Sixteen patients with metastatic urothelial cancer, previously treated with a platinum-based regimen, were studied. GC (gemcitabine 750 mg/m², on days 1, 8, and 15; carboplatin 200 mg/m², on day 2) was administered every 28 days to 15 patients. GDC (gemcitabine 750 mg/m², on days 1 and 8; docetaxel 50 mg/m², on day 1; carboplatin 200 mg/m² on day 1) was administered every 21 days to 9 patients. Eight of the 9 GDC-treated patients had earlier been treated with GC and had become refractory.

Results

With the GC therapy, 7 of the 15 treated patients (47%; 95% confidence interval, 21%–73%) showed an objective response, with 3 achieving a clinical complete response (CR) and 4 a partial response (PR). With the GDC therapy, 6 of the 9 treated patients (67%; 95% confidence interval, 29%–92%) showed an objective response, with 1 achieving CR and 5, PR. Five of the 8 (63%) GC-refractory patients responded to GDC therapy. The median duration of response was 4 months (range, 2–10+ months) on GC therapy, and 3 months (range, 3–5 months) on GDC therapy. Toxicities associated with GC were less than those with GDC.

Conclusion

GC was effective for refractory metastatic urothelial cancer, and GDC was effective for GC-refractory cancer.