title: Combination chemotherapy of docetaxel, ifosfamide and cisplatin (DIP) in patients with metastatic urothelial cancer: a preliminary report.
abstract: OBJECTIVE
  The aim of this study was to evaluate the efficacy and toxicity of a new combination chemotherapy of docetaxel, ifosfamide and cisplatin (DIP) in the treatment of metastatic urothelial cancer.
  
  
  METHODS
  Fourteen patients (nine male and five female; aged 59-82 years) with metastatic urothelial carcinoma, including five patients who have a history of methotrexate, vinblastine, doxorubicin and cisplatin (MVAC) chemotherapies, received the combination of docetaxel 60 mg/m(2) on day 1, and ifosfamide 1.0 g/m(2) and cisplatin 20 mg/m(2) on days 2-6 and repeated every 21 days, to a maximum of six cycles. Eligibility criteria included performance status (World Health Organization) 0-3; normal bone marrow and liver function; and no symptomatic peripheral neuropathy.
  
  
  RESULTS
  Ten of the 14 patients (72%) demonstrated a partial response (PR), with durations of response ranging from 3 to 12 months [median 6.5 months; 95% confidence interval (CI), 4.1-8.7 months]. The response rate of the five patients with MVAC-refractory cancer was 80% with median duration of response 5.5 months, comparable with that of the cases without previous MVAC therapies. Grade 3-4 granulocytopenia occurred in 10 cases (71%), resulting in three episodes (21%) of febrile neutropenia. Grade 3 thrombocytopenia was observed in five cases (36%). No toxic death was observed. Grade 2 peripheral neuropathy was identified in one case.
  
  
  CONCLUSIONS
  This pilot study demonstrated that DIP is an effective regimen for the treatment of metastatic urothelial cancer, and warrants further investigation.
authors.affiliation: Department of Urology, Faculty of Medicine, Tokyo University, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. takahashi-uro@h.u-tokyo.ac.jp
authors.forename: Satoru
authors.initials: S
authors.lastname: Takahashi
authors.forename: Makoto
authors.initials: M
authors.lastname: Suzuki
authors.forename: Haruki
authors.initials: H
authors.lastname: Kume
authors.forename: Shinya
authors.initials: S
authors.lastname: Matsumoto
authors.forename: Naohiko
authors.initials: N
authors.lastname: Okamoto
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nishimatsu
authors.forename: Kyoichi
authors.initials: K
authors.lastname: Tomita
authors.forename: Tadaichi
authors.initials: T
authors.lastname: Kitamura
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000380:Agranulocytosis / Q000139:chemically induced; D000740:Anemia / Q000139:chemically induced; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000556:secondary; D002945:Cisplatin / Q000008:administration & dosage; D000077143:Docetaxel; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D008175:Lung Neoplasms / Q000556:secondary; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D012983:Soft Tissue Neoplasms / Q000556:secondary; D043823:Taxoids / Q000008:administration & dosage; D013921:Thrombocytopenia / Q000139:chemically induced; D014571:Urologic Neoplasms / Q000188:drug therapy* / Q000473:pathology
chemical_list: D043823:Taxoids; D000077143:Docetaxel; D002945:Cisplatin; D007069:Ifosfamide