title: Gemcitabine in transitional cell carcinoma of the urothelium.
abstract: Gemcitabine has become one of the key drugs in the treatment of patients with locally advanced and metastatic transitional cell carcinoma of the urothelium. The overall response rate for single-agent gemcitabine is 25% with a complete response rate of 9% and toxicity is mild-to-modest. The overall response rate for gemcitabine combined with cisplatin (GC) in Phase II studies is 47% with a complete response rate of 18% and a median survival ranging from 12.5 to 14.3 months. A randomized Phase III study comparing GC and methotrexate, vinblastine, adriamycin and cisplatin (MVAC) has demonstrated similar efficacy with respect to response, time-to-progression and overall survival, whereas GC is associated with less toxicity than MVAC. Thus, GC is now considered a standard of care for patients with locally advanced and metastatic urothelial cancer. Other promising combinations include gemcitabine together with one of the taxanes with or without cisplatin.
authors.affiliation: Department of Oncology, Aarhus University Hospital, Denmark. hvdm@oncology.dk
authors.forename: Hans
authors.initials: H
authors.lastname: von der Maase
mesh_terms: D000818:Animals; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols; D002295:Carcinoma, Transitional Cell / Q000188:drug therapy*; D002945:Cisplatin / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D003841:Deoxycytidine / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D006801:Humans; D014571:Urologic Neoplasms / Q000188:drug therapy*; D019459:Urothelium / Q000473:pathology; D000093542:Gemcitabine
chemical_list: D000964:Antimetabolites, Antineoplastic; D000970:Antineoplastic Agents; D003841:Deoxycytidine; D002945:Cisplatin; D000093542:Gemcitabine