Published in:
01-08-2010 | Original Article
Long-term results of combined chemotherapy with gemcitabine and cisplatin for metastatic urothelial carcinomas
Published in: International Journal of Clinical Oncology | Issue 4/2010
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Background
This retrospective study aimed to determine the long-term effects and toxicity of a combined chemotherapeutic regimen of gemcitabine and cisplatin (GC) in the treatment of metastatic urothelial carcinomas (UCs).
Methods
Seventy-one patients with metastatic UC were treated with GC (gemcitabine 1000 mg/m2 on days 1, 8, and 15 and cisplatin 70 mg/m2 on day 2 every 28 days). The patients were divided into 3 groups: patients who had not undergone prior chemotherapy (group 1), patients who relapsed more than 6 months after being treated with the prior cisplatin-based regimen (group 2), and patients in whom the prior cisplatin-based regimen demonstrated no effect (group 3). The median follow-up was 42 months.
Results
In group 1, 20 of the 32 patients (63%) showed an objective response, with 6 achieving a clinically complete response (CR) and 14 a partial response (PR) with GC. Ten of 32 patients (31%) and 1 of 7 patients (14%) showed objective responses in groups 2 and 3, respectively. Patients in group 2 who had previously been treated with regimens other than GC showed a better objective response (58%) than those with GC (15%). The median time to progression in group 1 was 6 months, and the median overall survival was 14 months. In all, the nonhematological toxicities associated with GC were quite mild. Grade 3–4 toxicity was primarily hematological, including anemia (19%), neutropenia (36%), and thrombocytopenia (42%).
Conclusions
GC is therefore considered to be a highly effective and well-tolerated regimen with moderate toxicity for the treatment of metastatic UCs.