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The effect of gemcitabine/paclitaxel chemotherapy on the survival of patients with metastatic urothelial cancers

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Abstract

Background

To evaluate the survival benefit of gemcitabine and paclitaxel (GT) chemotherapy for patients with metastatic urothelial cancer (UC), a retrospective analysis was performed to compare the overall survival in two periods: before (group I) and after (group II) the introduction of GT chemotherapy.

Patients and methods

Eighty-five patients with metastatic UC were treated with MEC/MVAC (methotrexate, epirubicin, and cisplatin / methotrexate, vinblastine, doxorubicin, and cisplatin) or GT between 1995 and 2007. The response rate, maintenance rate, maintenance duration of each regimen, and the survival times of responding patients in each group were evaluated retrospectively.

Results

The median survival of patients in group ΙI (20 months) was significantly longer than that for group I (13 months) (p = 0.03). Especially in patients with a favorable response (CR/PR) to induction chemotherapy, the median survival period was significantly different between group Ι and group II (median 15 and 28 months, respectively; p = 0.02). The rate of the shift to maintenance chemotherapy when using GT chemotherapy was significantly higher than with MEC/MVAC chemotherapy alone (p < 0.05), and the cessation rate due to adverse effects was significantly lower when using GT chemotherapy (26.1%) than MEC/MVAC in group Ι (42.1%).

Conclusion

Our results demonstrated that the administration of GT chemotherapy may be useful to improve the survival of patients with metastatic UC. This effect was significant, especially among those who were sensitive to the induction course of first-line chemotherapy. The excellent tolerability of GT regimens mean that they may be suitable for maintenance chemotherapy.

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Conflict of interest

The authors have no conflicts of interest to declare.

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Authors and Affiliations

  1. Department of Urology, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan

    Yoshiyuki Matsui, Koji Yoshimura, Nai-Dong Xing, Ryoichi Saito, Takahiro Inoue, Tomomi Kamba & Osamu Ogawa

  2. Department of Urology, Institute of Clinical Medicine, University of Tsukuba Graduate School of Comprehensive Human Sciences, Tsukuba, Ibaraki, Japan

    Hiroyuki Nishiyama

  3. Department of Urology, Osaka Red Cross Hospital, Osaka, Japan

    Takayuki Sumiyoshi

Authors
  1. Yoshiyuki Matsui
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  2. Hiroyuki Nishiyama
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  3. Koji Yoshimura
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  4. Nai-Dong Xing
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  5. Takayuki Sumiyoshi
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  6. Ryoichi Saito
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  7. Takahiro Inoue
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  8. Tomomi Kamba
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  9. Osamu Ogawa
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Corresponding author

Correspondence to Osamu Ogawa.

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Matsui, Y., Nishiyama, H., Yoshimura, K. et al. The effect of gemcitabine/paclitaxel chemotherapy on the survival of patients with metastatic urothelial cancers. Int J Clin Oncol 18, 321–328 (2013). https://doi.org/10.1007/s10147-012-0381-0

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  • DOI: https://doi.org/10.1007/s10147-012-0381-0

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