Gemcitabine and paclitaxel chemotherapy for advanced urothelial carcinoma in patients who have received prior cisplatin-based chemotherapy

Kunimitsu Kanai, Eiji Kikuchi, Takashi Ohigashi, Akira Miyajima, Ken Nakagawa, Jun Nakashima, Mototsugu Oya

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Abstract

Background. The objective of this study was to evaluate the efficacy and toxicity of combination chemotherapy with gemcitabine and paclitaxel as a second-line regimen in patients with advanced urothelial carcinoma. Methods. Twenty patients with advanced urothelial carcinoma who were resistant to an M-VAC (methotrexate, vinblastine, doxorubicin, and cisplatin) chemotherapy regimen were administered chemotherapy consisting of intravenous gemcitabine 2500 mg/m2 and paclitaxel 150 mg/m2 (GP) every 2 or 3 weeks. Results. The patients received a median of 7.7 cycles of treatment (range, 2-20 cycles). Six of the 20 patients (30%; 95% confidence interval [CI], 10%-50%) had a major response to treatment (a complete response [CR] in 5% and a partial response [PR] in 25%). Seven patients (35%) had stable disease (SD). The median duration of response was 4.5 months (range, 1-9 months) and the disease control rate (CR + PR + SD) was 65%. The median survival was 11.5 months (range, 2-22 months) and the 1-year survival rate was 35%. The patients tolerated this regimen well, with only grade 3-4 neutropenia being observed in 6 patients (30%), anemia in 3 (15%), and thrombocytopenia in 1 (5%). The response rate to M-VAC in the first-line chemotherapy was significantly associated with the response to GP as the second-line chemotherapy. Conclusion. The combination of gemcitabine and paclitaxel is active and well tolerated as a second-line treatment in patients with advanced urothelial carcinoma.

Original languageEnglish
Pages (from-to)510-514
Number of pages5
JournalInternational Journal of Clinical Oncology
Volume13
Issue number6
DOIs
Publication statusPublished - 2008 Dec

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gemcitabine
Paclitaxel
Cisplatin
Carcinoma
Drug Therapy
Vinblastine
Methotrexate
Doxorubicin
Combination Drug Therapy
Neutropenia
Anemia

Keywords

  • Gemcitabine
  • Paclitaxel
  • Second-line chemotherapy
  • Urothelial carcinoma

ASJC Scopus subject areas

  • Oncology
  • Surgery
  • Hematology

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Gemcitabine and paclitaxel chemotherapy for advanced urothelial carcinoma in patients who have received prior cisplatin-based chemotherapy. / Kanai, Kunimitsu; Kikuchi, Eiji; Ohigashi, Takashi; Miyajima, Akira; Nakagawa, Ken; Nakashima, Jun; Oya, Mototsugu.

In: International Journal of Clinical Oncology, Vol. 13, No. 6, 12.2008, p. 510-514.

Research output: Contribution to journalArticle

Kanai, Kunimitsu ; Kikuchi, Eiji ; Ohigashi, Takashi ; Miyajima, Akira ; Nakagawa, Ken ; Nakashima, Jun ; Oya, Mototsugu. / Gemcitabine and paclitaxel chemotherapy for advanced urothelial carcinoma in patients who have received prior cisplatin-based chemotherapy. In: International Journal of Clinical Oncology. 2008 ; Vol. 13, No. 6. pp. 510-514.
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AU - Miyajima, Akira

AU - Nakagawa, Ken

AU - Nakashima, Jun

AU - Oya, Mototsugu

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N2 - Background. The objective of this study was to evaluate the efficacy and toxicity of combination chemotherapy with gemcitabine and paclitaxel as a second-line regimen in patients with advanced urothelial carcinoma. Methods. Twenty patients with advanced urothelial carcinoma who were resistant to an M-VAC (methotrexate, vinblastine, doxorubicin, and cisplatin) chemotherapy regimen were administered chemotherapy consisting of intravenous gemcitabine 2500 mg/m2 and paclitaxel 150 mg/m2 (GP) every 2 or 3 weeks. Results. The patients received a median of 7.7 cycles of treatment (range, 2-20 cycles). Six of the 20 patients (30%; 95% confidence interval [CI], 10%-50%) had a major response to treatment (a complete response [CR] in 5% and a partial response [PR] in 25%). Seven patients (35%) had stable disease (SD). The median duration of response was 4.5 months (range, 1-9 months) and the disease control rate (CR + PR + SD) was 65%. The median survival was 11.5 months (range, 2-22 months) and the 1-year survival rate was 35%. The patients tolerated this regimen well, with only grade 3-4 neutropenia being observed in 6 patients (30%), anemia in 3 (15%), and thrombocytopenia in 1 (5%). The response rate to M-VAC in the first-line chemotherapy was significantly associated with the response to GP as the second-line chemotherapy. Conclusion. The combination of gemcitabine and paclitaxel is active and well tolerated as a second-line treatment in patients with advanced urothelial carcinoma.

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