title: Gemcitabine plus carboplatin; and gemcitabine, docetaxel, and carboplatin combined chemotherapy regimens in patients with metastatic urothelial carcinoma previously treated with a platinum-based regimen: preliminary report.
abstract: BACKGROUND
  The aim of this study was to evaluate the efficacy and safety of two combined chemotherapy regimens in the treatment of previously treated metastatic urothelial carcinoma: gemcitabine plus carboplatin (GC), and gemcitabine, docetaxel, and carboplatin (GDC).
  
  
  METHODS
  Sixteen patients with metastatic urothelial cancer, previously treated with a platinum-based regimen, were studied. GC (gemcitabine 750 mg/m(2), on days 1, 8, and 15; carboplatin 200 mg/m(2), on day 2) was administered every 28 days to 15 patients. GDC (gemcitabine 750 mg/m(2), on days 1 and 8; docetaxel 50 mg/m(2), on day 1; carboplatin 200 mg/m(2) on day 1) was administered every 21 days to 9 patients. Eight of the 9 GDC-treated patients had earlier been treated with GC and had become refractory.
  
  
  RESULTS
  With the GC therapy, 7 of the 15 treated patients (47%; 95% confidence interval, 21%-73%) showed an objective response, with 3 achieving a clinical complete response (CR) and 4 a partial response (PR). With the GDC therapy, 6 of the 9 treated patients (67%; 95% confidence interval, 29%-92%) showed an objective response, with 1 achieving CR and 5, PR. Five of the 8 (63%) GC-refractory patients responded to GDC therapy. The median duration of response was 4 months (range, 2-10+ months) on GC therapy, and 3 months (range, 3-5 months) on GDC therapy. Toxicities associated with GC were less than those with GDC.
  
  
  CONCLUSIONS
  GC was effective for refractory metastatic urothelial cancer, and GDC was effective for GC-refractory cancer. The aim of this study was to evaluate the efficacy and safety of two combined chemotherapy regimens in the treatment of previously treated metastatic urothelial carcinoma: gemcitabine plus carboplatin (GC), and gemcitabine, docetaxel, and carboplatin (GDC).
authors.affiliation: Department of Urology, Yamagata Prefectural Medical Center for Cancer and Life-Style Related Disease, 1800 Aoyagi, 990-2292, Yamagata, Japan. hoshi@uro.med.tohoku.ac.jp
authors.forename: Senji
authors.initials: S
authors.lastname: Hoshi
authors.forename: Chikara
authors.initials: C
authors.lastname: Ohyama
authors.forename: Kunio
authors.initials: K
authors.lastname: Ono
authors.forename: Atsushi
authors.initials: A
authors.lastname: Takeda
authors.forename: Shinichi
authors.initials: S
authors.lastname: Yamashita
authors.forename: Takashi
authors.initials: T
authors.lastname: Yamato
authors.forename: Akihiro
authors.initials: A
authors.lastname: Itoh
authors.forename: Makoto
authors.initials: M
authors.lastname: Satoh
authors.forename: Seiichi
authors.initials: S
authors.lastname: Saito
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Okada
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Sohma
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Arai
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016190:Carboplatin / Q000008:administration & dosage; D002295:Carcinoma, Transitional Cell / Q000188:drug therapy* / Q000473:pathology; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D000077143:Docetaxel; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D010865:Pilot Projects; D043823:Taxoids / Q000008:administration & dosage; D016896:Treatment Outcome; D014516:Ureteral Neoplasms / Q000188:drug therapy* / Q000473:pathology; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy* / Q000473:pathology; D000093542:Gemcitabine
chemical_list: D043823:Taxoids; D003841:Deoxycytidine; D000077143:Docetaxel; D016190:Carboplatin; D000093542:Gemcitabine