301. Combination of gemcitabine and paclitaxel as second-line chemotherapy for advanced urothelial carcinoma.
- Author
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Suyama T, Ueda T, Fukasawa S, Imamura Y, Nakamura K, Miyasaka K, Sazuka T, Egoshi K, Nihei N, Hamano M, Ichikawa T, and Maruoka M
- Subjects
- Adrenal Gland Neoplasms secondary, Aged, Antineoplastic Combined Chemotherapy Protocols adverse effects, Carcinoma secondary, Deoxycytidine administration & dosage, Deoxycytidine analogs & derivatives, Drug Eruptions etiology, Female, Humans, Liver Neoplasms secondary, Lung Neoplasms secondary, Male, Middle Aged, Paclitaxel administration & dosage, Peripheral Nervous System Diseases chemically induced, Prognosis, Survival Rate, Thrombocytopenia chemically induced, Gemcitabine, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Carcinoma drug therapy, Carcinoma mortality, Urinary Bladder Neoplasms drug therapy, Urinary Bladder Neoplasms mortality
- Abstract
Objective: The aim of this study was to evaluate the efficacy and toxicities of the gemcitabine and paclitaxel combination regimen as second-line chemotherapy for patients with advanced or metastatic urothelial carcinoma (UC) who have previously been treated with platinum-based chemotherapy for the metastatic disease., Methods: Thirty-three patients with advanced or metastatic UC who had received platinum-based chemotherapy were treated with an outpatient gemcitabine and paclitaxel combination regimen. A dose of 180 mg/m(2) paclitaxel was administered by intravenous (IV) infusion on Day 1, and 1000 mg/m(2) gemcitabine was administered by IV on Days 1, 8 and 15.The course was repeated every 28 days. Patients were evaluated after every 2 cycles of therapy using computed tomography., Results: Of the 33 patients enrolled in this study, 30 could be evaluated to determine treatment efficacy; 10 had an objective response [overall response rate: 33.3%, 95% confidence interval (CI), 19.2-51.2%]. The median overall survival was 11.3 months (95% CI, 7.2-13.6 months). The chemotherapy sensitivity differed with disease site. The response rates of lung and bone metastases were 27% and 14%, and the progressive disease (PD) rates of lung and bone metastases were 13% and 14%, respectively. On the other hand, the response rate of liver metastasis was 14%, and its PD rate was 57%. None of the patients (n = 3) with adrenal metastasis responded to this regimen. Toxicities were mild, and no life-threatening complications occurred., Conclusions: Gemcitabine and paclitaxel combination therapy is a tolerable and active regimen for patients with advanced UC after failure of platinum-based chemotherapy.
- Published
- 2009
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