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1151 Gemcitabine plus paclitaxel as third-line chemotherapy: A feasible option for metastatic urothelial carcinoma patients
1151
Gemcitabine plus paclitaxel as third‐line chemotherapy: A feasible option for metastatic urothelial carcinoma patients Eur Urol Suppl 2016;15(3);e1151
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Iida K., Nagai T., Etani T., Naiki T., Ando R., Kawai N., Tozawa K., Yasui T. Nagoya City University, Graduate School Of Medical Sciences, Dept. of Nephro-urology, Nagoya, Japan INTRODUCTION & OBJECTIVES: We previously reported the efficacy of Gemcitabine and Docetaxel (GD) combination as a second‐line treatment strategy for patients with metastatic Urothelial Carcinoma (UC) after failure of the first‐line treatment with platinum‐based chemotherapy. However, the efficacy of GD was not sufficient to be established as a standard second‐line treatment. The treatment options are limited for patients who demonstrate good performance status following GC or GD therapy. This study was conducted to evaluate the effectiveness of a combination of gemcitabine and paclitaxel therapy for patients with metastatic UC that was previously treated with two lines of chemotherapy. MATERIAL & METHODS: Between January 2006 and May 2015, 91 patients were treated with GD as second‐line chemotherapy. All had received first‐line chemotherapy consisting of cisplatin. After the failure of the second‐line GD therapy, 13 patients received a combination of Gemcitabine and Paclitaxel (GP) as a third line treatment. This consisted of gemcitabine (1000 mg/m2 ) on days 1, 8, and 15 and paclitaxel (200 mg/m2 ) on day 1 of each 21‐day cycle. All patients were evaluated for toxicity, and were assessed at every cycle by imaging studies. In addition, Quality Of Life (QOL) was estimated by using the Short Form Health Survey (SF‐36) questionnaire. We analysed the efficacy of GP as third‐line chemotherapy in the follow‐up study. RESULTS: The median number of GP treatment cycles was 4 (range 2 to 8). The objective response rate was 23.1%. The median progression‐free survival and the median overall survival after the end of second‐line GD therapy were 4.1 months and 10.8 months, respectively. Univariate and multivariate analyses of the GD‐treated group showed that good performance status was the only prognostic factor for tumour response. Grade 3 treatment‐related toxicity included neutropenia (77%) and thrombocytopenia (62%), and none of the patients showed grade 4 toxicity. The QOL score after 2 cycles of third‐line GP therapy was not significantly decreased compared to the pre‐treatment scores.
CONCLUSIONS: GP combination chemotherapy as a third‐line regimen is a favourable option for patients with metastatic UC. Given the safety and benefit profile including QOL observed in this study, further prospective trials are warranted to evaluate this strategic chemotherapy approach for patients with metastatic UC.
Gemcitabine plus paclitaxel as third‐line chemotherapy: A feasible option for metastatic urothelial carcinoma patients Eur Urol Suppl 2016;15(3);e1151
Print! Print!
Iida K., Nagai T., Etani T., Naiki T., Ando R., Kawai N., Tozawa K., Yasui T. Nagoya City University, Graduate School Of Medical Sciences, Dept. of Nephro-urology, Nagoya, Japan INTRODUCTION & OBJECTIVES: We previously reported the efficacy of Gemcitabine and Docetaxel (GD) combination as a second‐line treatment strategy for patients with metastatic Urothelial Carcinoma (UC) after failure of the first‐line treatment with platinum‐based chemotherapy. However, the efficacy of GD was not sufficient to be established as a standard second‐line treatment. The treatment options are limited for patients who demonstrate good performance status following GC or GD therapy. This study was conducted to evaluate the effectiveness of a combination of gemcitabine and paclitaxel therapy for patients with metastatic UC that was previously treated with two lines of chemotherapy. MATERIAL & METHODS: Between January 2006 and May 2015, 91 patients were treated with GD as second‐line chemotherapy. All had received first‐line chemotherapy consisting of cisplatin. After the failure of the second‐line GD therapy, 13 patients received a combination of Gemcitabine and Paclitaxel (GP) as a third line treatment. This consisted of gemcitabine (1000 mg/m2 ) on days 1, 8, and 15 and paclitaxel (200 mg/m2 ) on day 1 of each 21‐day cycle. All patients were evaluated for toxicity, and were assessed at every cycle by imaging studies. In addition, Quality Of Life (QOL) was estimated by using the Short Form Health Survey (SF‐36) questionnaire. We analysed the efficacy of GP as third‐line chemotherapy in the follow‐up study. RESULTS: The median number of GP treatment cycles was 4 (range 2 to 8). The objective response rate was 23.1%. The median progression‐free survival and the median overall survival after the end of second‐line GD therapy were 4.1 months and 10.8 months, respectively. Univariate and multivariate analyses of the GD‐treated group showed that good performance status was the only prognostic factor for tumour response. Grade 3 treatment‐related toxicity included neutropenia (77%) and thrombocytopenia (62%), and none of the patients showed grade 4 toxicity. The QOL score after 2 cycles of third‐line GP therapy was not significantly decreased compared to the pre‐treatment scores.
CONCLUSIONS: GP combination chemotherapy as a third‐line regimen is a favourable option for patients with metastatic UC. Given the safety and benefit profile including QOL observed in this study, further prospective trials are warranted to evaluate this strategic chemotherapy approach for patients with metastatic UC.