Gemcitabine, paclitaxel, and cisplatin as combined adjuvant approach in transitional cell carcinoma of the urothelium

Minerva Urol Nefrol. 2009 Sep;61(3):249-56.

Abstract

Aim: The objective of this study was to evaluate the adjuvant chemotherapy with gemcitabine, paclitaxel, and cisplatin for urothelial carcinoma.

Methods: Twenty-seven patients with invasive transitional cell carcinoma of the urothelium were treated between 2001 and 2007. All patients received chemotherapy with intravenous gemcitabine at a dose of 1000 mg/mC on Days 1 and 8, intravenous paclitaxel at a dose of 80 mg/mC on Days 1 and 8, and intravenous cisplatin at a dose of 50 mg/mC on Day 2. Treatment courses were repeated every 21 days.

Results: Median follow-up period was 32.5 months. Six patients came to progressive disease. The median overall survival was not reached, and the actuarial 1-year and 2-year survival rates were 89% and 67% respectively. The median progression-free survival was 10.0 months. Median survival time for patients with ECOG status 0, and 1 was 52.0, and 22.0 months respectively. Grade 4 neutropenia occurred in 18.5% of patients, but there was no treatment related mortality.

Conclusions: The combination of gemcitabine, paclitaxel, and cisplatin is a highly effective and tolerable regimen for patients with invasive transitional cell carcinoma of the urothelium. This treatment should be considered as a suitable option that deserves further prospective evaluation. ECOG performance status is an important predictive factors for survival.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents / administration & dosage*
  • Carcinoma, Transitional Cell / drug therapy*
  • Chemotherapy, Adjuvant
  • Cisplatin / administration & dosage*
  • Deoxycytidine / administration & dosage
  • Deoxycytidine / analogs & derivatives*
  • Female
  • Gemcitabine
  • Humans
  • Kidney Neoplasms / drug therapy*
  • Kidney Pelvis*
  • Male
  • Middle Aged
  • Paclitaxel / administration & dosage*
  • Retrospective Studies
  • Ureteral Neoplasms / drug therapy*
  • Urinary Bladder Neoplasms / drug therapy*

Substances

  • Antineoplastic Agents
  • Deoxycytidine
  • Paclitaxel
  • Cisplatin
  • Gemcitabine