title: Paclitaxel in advanced urothelial carcinoma: its role in patients with renal insufficiency and as salvage therapy.
abstract: OBJECTIVE
  We evaluated the role of paclitaxel in patients with advanced urothelial carcinoma and renal insufficiency or as second line therapy for metastatic disease.
  
  
  METHODS
  Nine patients with advanced urothelial carcinoma received 175 to 250 mg./m2. paclitaxel intravenously as a 24-hour infusion. Six patients had renal insufficiency with a median serum creatinine of 2.25 mg./dl. (range 1.9 to 3.2) and 3 with normal renal function were treated after disease progression following 1 to 2 prior chemotherapy regimens.
  
  
  RESULTS
  Of 9 patients 5 (56%) achieved a partial response, including 4 of 6 with renal insufficiency. Toxicity was primarily hematological with 4 patients experiencing febrile neutropenia. There was no adverse impact on renal function.
  
  
  CONCLUSIONS
  Paclitaxel as a single agent represents an effective therapeutic alternative for patients with advanced transitional cell carcinoma of the urothelium and renal insufficiency precluding cisplatin or gallium nitrate based chemotherapy. Additionally, paclitaxel appears to be effective in patients in whom prior cisplatin based therapy failed.
authors.affiliation: Departments of Internal Medicine and Urology, University of Iowa, Iowa City, USA.
authors.forename: R
authors.initials: R
authors.lastname: Dreicer
authors.forename: D M
authors.initials: DM
authors.lastname: Gustin
authors.forename: W A
authors.initials: WA
authors.lastname: See
authors.forename: R D
authors.initials: RD
authors.lastname: Williams
mesh_terms: D000328:Adult; D000368:Aged; D000972:Antineoplastic Agents, Phytogenic / Q000627:therapeutic use*; D002295:Carcinoma, Transitional Cell / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D017239:Paclitaxel / Q000627:therapeutic use*; D051437:Renal Insufficiency / Q000150:complications*; D016879:Salvage Therapy; D001749:Urinary Bladder Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D019459:Urothelium
chemical_list: D000972:Antineoplastic Agents, Phytogenic; D017239:Paclitaxel