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

被引:15
作者
Hoshi S. [1 ]
Ohyama C. [2 ]
Ono K. [1 ]
Takeda A. [3 ]
Yamashita S. [3 ]
Yamato T. [3 ]
Itoh A. [3 ]
Satoh M. [3 ]
Saito S. [3 ]
Okada Y. [4 ]
Sohma F. [5 ]
Arai Y. [3 ]
机构
[1] Department of Urology, Yamagata Pref. Med. Ctr. for Cancer, Yamagata 990-2292
[2] Department of Urology, Akita University School of Medicine, Akita
[3] Department of Urology, Tohoku Univ. Grad. Sch. of Medicine, Sendai
[4] Department of Urology, Kesennuma City Hospital, Kesennuma
[5] Department of Urology, Hachinohe City Hospital, Hachinohe
关键词
Docetaxel; Gemcitabine; Metastatic urothelial cancer;
D O I
10.1007/s10147-003-0379-8
中图分类号
学科分类号
摘要
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.
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页码:125 / 129
页数:4
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共 20 条
[1]  
Hertel L.W., Boder G.B., Kroin J.S., Et al., Evaluation of the antitumor activity of gemcitabine (2′,2′ -difluoro-2′-deoxycytidine), Cancer Res, 50, pp. 4417-4422, (1990)
[2]  
Lorusso V., Pollera C.F., Antimi M., Et al., A phase II study of gemcitabine in patients with transitional cell carcinoma of the urinary tract previously treated with platinum, Eur J Cancer, 34, pp. 1208-1212, (1998)
[3]  
Stadler W.M., Kuzel T., Roth B., Et al., Phase II study of single-agent gemcitabine in previously untreated patients with metastatic urothelial cancer, J Clin Oncol, 15, pp. 3394-3398, (1997)
[4]  
Vaishampayan U., Parchment R.E., Jasti B.R., Et al., Taxanes: An overview of the pharmacokinetics and pharmacodynamics, Urology, 54, SUPPL. 6A, pp. 22-29, (1999)
[5]  
Haldar S., Basu A., Croce C.M., Bcl2 is the guardian of microtubule integrity, Cancer Res, 57, pp. 229-233, (1997)
[6]  
Sternberg C.N., Yagoda A., Scher H.I., Et al., Methotrexate, vinblastine, doxorubicin, and cisplatin for advanced transitional cell carcinoma of the urothelium. Efficacy and patterns of response and relapse, Cancer, 64, pp. 2448-2458, (1989)
[7]  
Bellmunt J., Guillem V., Paz-Ares L., Et al., Gemcitabine/paclitaxel-based three-drug regimens in advanced urothelial cancer, Eur J Cancer, 36, SUPPL. 2, pp. 17-25, (2000)
[8]  
Kuroda M., Kotake T., Akaza H., Et al., Efficacy of dose-intensified MEC (methotrexate, epirubicin and cisplatin) chemotherapy for advanced urothelial carcinoma: A prospective randomized trial comparing MEC and M-VAC (methotrexate, vinblastine, doxorubicin and cisplatin), Jpn J Clin Oncol, 28, pp. 497-501, (1998)
[9]  
Bajorin D.F., McCaffrey J.A., Dodd P.M., Et al., Ifosfamide, paclitaxel, and cisplatin for patients with advanced transitional cell carcinoma of the urothelial tract: Final report of a phase II trial evaluating two dosing schedules, Cancer, 88, pp. 1671-1678, (2000)
[10]  
Lorusso V., Manzione L., De Vita F., Et al., Gemcitabine plus cisplatin for advanced transitional cell carcinoma of the urinary tract: A phase II multicenter trial, J Urol, 164, pp. 53-56, (2000)