Abstract
Background
The aim of this study was to evaluate the efficacy and safety of a combined chemotherapy regimen, gemcitabine and cisplatin (GC), in the treatment of advanced urothelial carcinomas.
Methods
Fifty-five patients with advanced urothelial cancer were treated with GC (gemcitabine 1000 mg/m2 on days 1, 8, and 15; cisplatin 70 mg/m2 on day 2) every 28 days. The median follow-up was 30 months (range, 3 to 57 months).
Results
With the GC therapy, 35 of the 55 patients (63.6%) showed an objective response, with 7 (12.7%) achieving a clinical complete response (CR) and 28 (50.9%), a partial response (PR). GC therapy had a better impact on metastases in the lung and lymph nodes than on metastases in the liver and bone. Lung and lymph nodes showed objective responses of 64.7% and 65.8%, respectively. Eight of the 20 patients (40.0%) who had previously been treated with other regimens showed an objective response, with 1 achieving a CR and 7 achieving a PR. In the 47 patients with metastasis, the median time to progression was 7.0 months (range, 2 to 49 months), and the median overall survival was 12.0 months (range, 3 to 49 months). The 2-year survival rate was 80.0% in the CR group, while it was 55.1% in the PR group and 10.0% in the progressive disease (PD) group. The toxicities associated with GC, particularly mucositis, anorexia, and alopecia, were quite mild. Grade 3–4 toxicity was primarily hematological, including anemia (27.3%), neutropenia (32.7%), and thrombocytopenia (43.6%).
Conclusion
GC is considered to be a highly effective and well-tolerated regimen for the treatment of advanced urothelial carcinomas, with moderate toxicity.
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References
CN Sternberg A Yagoda HI Scher et al. (1989) ArticleTitleMethotrexate, vinblastine, doxorubicine, and cisplatin for advanced transitional cell carcinoma of the urothelium Cancer 64 2448–2458 Occurrence Handle2819654 Occurrence Handle10.1002/1097-0142(19891215)64:12<2448::AID-CNCR2820641209>3.0.CO;2-7 Occurrence Handle1:STN:280:By%2BD2MfktVY%3D
I Tannock M Gospodarowicz J Connolly et al. (1989) ArticleTitleM-VAC (methotrexate, vinblastine, doxorubicin and cisplatin) chemotherapy for transitional cell carcinoma: the Princess Margaret Hospital experience J Urol 142 289–292 Occurrence Handle2746745 Occurrence Handle1:STN:280:BiaA3M7ms1I%3D
LW Hertel GB Boder JS Kroin et al. (1990) ArticleTitleEvaluation of the antitumor activity of gemcitabine (2′,2′-difluoro-2′-deoxycytidine) Cancer Res 50 4417–4422 Occurrence Handle2364394 Occurrence Handle1:CAS:528:DyaK3cXkvFWjtb4%3D
SB Saxman KJ Propert LH Einhorn et al. (1990) ArticleTitleLong term follow up of a phase III intergroup study of cisplatin alone or in combination with methotrexate, vinblastine and doxorubicin in patients with metastatic urothelial carcinoma: a cooperative group study J Clin Oncol 15 2564–2569
CL Logothetis FH Dexeus A Sella et al. (1990) ArticleTitleEscalated therapy for refractory urothelial tumors: methotrexate-vinblastine-doxorubicin- cisplatin plus ongoing unglycosylated recombinant human granulocyte-macrophage colony-stimulating factor J Natl Cancer Inst 82 667–672 Occurrence Handle2181151 Occurrence Handle10.1093/jnci/82.8.667 Occurrence Handle1:STN:280:By%2BB3cvlslc%3D
V Lorusso CF Pollera M Antimi et al. (1998) ArticleTitleA phase II study of gemcitabine in patients with transitional cell carcinoma of the urinary tract previously treated with platinum. Italian Co-operative Group on Bladder Cancer Eur J Cancer 34 1208–1212 Occurrence Handle9849481 Occurrence Handle10.1016/S0959-8049(98)00030-6 Occurrence Handle1:CAS:528:DyaK1cXltlCgsr4%3D
WM Stadler T Kuzel B Roth et al. (1997) ArticleTitlePhase II study of single-agent gemcitabine in previously untreated patients with metastatic urothelial cancer J Clin Oncol 15 3394–3398 Occurrence Handle9363871 Occurrence Handle1:CAS:528:DyaK2sXnsVensb0%3D
BJ Roth D Bajorin (1995) ArticleTitleAdvanced bladder cancer: the need to identify new agents in the post-M-VAC (methotrexate, vinblastine, doxorubicin and cisplatin) World J Urol 153 894–900 Occurrence Handle1:STN:280:ByqC2Mnms1M%3D
H von der Maase SW Hansen JT Roberts et al. (2000) ArticleTitleGemcitabine and cisplatin versus methotrexate, vinblastine, doxorubicin, and cisplatin in advanced or metastatic bladder cancer: results of a large, randomized, multinational, multicenter, phase III study J Clin Oncol 17 3068–3077
D Kaufman D Raghavan M Carducci et al. (2000) ArticleTitlePhase II trial of gemcitabine plus cisplatin in patients with metastatic urothelial cancer J Clin Oncol 18 1921–1927 Occurrence Handle10784633 Occurrence Handle1:CAS:528:DC%2BD3cXjvVentr0%3D
MJ Moore E Winquist N Murray et al. (1999) ArticleTitleGemcitabine plus cisplatin, an active regimen in advanced urothelial cancer: a phase II trial of the National Cancer Institute of Canada Clinical Trials Group J Clin Oncol 17 2876–2880 Occurrence Handle10561365 Occurrence Handle1:CAS:528:DyaK1MXmtlWqsr8%3D
InstitutionalAuthorNameWorld Health Organization (1979) WHO Handbook for reporting results of cancer treatment WHO Geneva
S Hoshi C Ohyama K Ono et al. (2004) ArticleTitleGemcitabine 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 Int J Clin Oncol 9 126–129 Occurrence Handle10.1007/s10147-003-0379-8
HB Grossman RB Natale CM Tangen et al. (2003) ArticleTitleNeoadjuvant chemotherapy plus cystectomy compared with cystectomy alone for locally advanced bladder cancer N Engl J Med 349 859–866 Occurrence Handle12944571 Occurrence Handle10.1056/NEJMoa022148 Occurrence Handle1:CAS:528:DC%2BD3sXmvVSnu7Y%3D
InstitutionalAuthorNameAdvanced Bladder Cancer Meta-analysis Collaboration (2003) ArticleTitleNeoadjuvant chemotherapy in invasive bladder cancer: a systematic review and meta-analysis Lancet 361 1927–1934 Occurrence Handle10.1016/S0140-6736(03)13580-5
Y Matsui H Nishiyama J Watanabe et al. (2005) ArticleTitleThe current status of perioperative chemotherapy for invasive bladder cancer: a multiinstitutional retrospective study in Japan J Clin Oncol 10 133–138
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Ozawa, A., Tanji, N., Ochi, T. et al. Gemcitabine and cisplatin for advanced urothelial carcinomas: the Ehime University Hospital experience. Int J Clin Oncol 12, 279–283 (2007). https://doi.org/10.1007/s10147-007-0678-6
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DOI: https://doi.org/10.1007/s10147-007-0678-6