title: Exploring sequenced chemotherapy regimens in the treatment of transitional cell carcinoma of the urothelial tract.
abstract: This phase I trial evaluated the two-drug regimen doxorubicin and gemcitabine (AG) every other week for six cycles followed by ifosfamide, paclitaxel and cisplatin (ITP) every 3 weeks for four cycles in patients with transitional cell carcinoma of the urothelial tract. 15 patients were treated at five AG dose levels ranging up to doxorubicin 50 mg/m(2) and gemcitabine 2000 mg/m(2). The dose and schedule of ITP were constant at ifosfamide 1500 mg/m(2) on days 1-3 and paclitaxel 200 mg/m(2) and cisplatin 70 mg/m(2) on day 1. Granulocyte colony-stimulating factor was self-administered between all cycles of therapy. The trial determined that AG given at alternating weeks at doses of doxorubicin 50 mg/m(2) and gemcitabine 2000 mg/m(2) was feasible. After completion of the AG-ITP sequence, 9 of 14 (64%) evaluable patients had a major response (3 complete responses and 6 partial responses). Phase II investigation at the highest dose level is ongoing.
authors.affiliation: Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021, USA.
authors.forename: D F
authors.initials: DF
authors.lastname: Bajorin
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002295:Carcinoma, Transitional Cell / Q000188:drug therapy*; D002945:Cisplatin / Q000008:administration & dosage; D003520:Cyclophosphamide / Q000008:administration & dosage; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D004317:Doxorubicin / Q000008:administration & dosage; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D008727:Methotrexate / Q000008:administration & dosage; D017239:Paclitaxel / Q000008:administration & dosage; D016896:Treatment Outcome; D014571:Urologic Neoplasms / Q000188:drug therapy*; D014747:Vinblastine / Q000008:administration & dosage; D000093542:Gemcitabine
chemical_list: D003841:Deoxycytidine; D014747:Vinblastine; D004317:Doxorubicin; D003520:Cyclophosphamide; D017239:Paclitaxel; D002945:Cisplatin; D007069:Ifosfamide; D008727:Methotrexate; D000093542:Gemcitabine