title: Cisplatin, gemcitabine and paclitaxel triplet chemotherapy in 50 patients with advanced or metastatic urothelial cancer.
abstract: At West Virginia University in Morgantown, we conducted a phase 2 study to investigate 50-mg/m2 cisplatin, 1,000-mg/m2 gemcitabine, and 75-mg/m2 paclitaxel (CGP) "triplet" chemotherapy for advanced urothelial cancer. Fifty patients received CGP days 1 and 8 of a 3- to 4-week cycle. Transitional cell carcinoma alone occurred in 38 patients; 12 had mixed histologic findings (adenocarcinoma or squamous cell carcinoma). Thirty-one (M0) had advanced regional disease; 19 (M1) had metastases. NCI performance status was 0 to 2 in 33 patients and 3 to 4 in 17 patients. Grade 3 or 4 toxicity occurred in 33% of patients administered 218 chemotherapy cycles. Objective tumor responses occurred in 11 M1 patients (complete in 2) and in 17 M0 patients (complete in 11). Median survival was 13.5 (M1) and 16.8 (M0) months. Our study shows that CGP for urothelial cancer is effective and has manageable toxicity. Seventy percent of our patients were ineligible for standard clinical trials.
authors.affiliation: Dept. of Medicine, West Virginia University School of Medicine, Morgantown, USA.
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Hogan
authors.forename: Donald L
authors.initials: DL
authors.lastname: Lamm
authors.forename: Gisa B
authors.initials: GB
authors.lastname: Schuun
authors.forename: Jose L
authors.initials: JL
authors.lastname: Hernadez
authors.forename: Stanley J
authors.initials: SJ
authors.lastname: Kandzari
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy; D002295:Carcinoma, Transitional Cell / Q000188:drug therapy; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D003841:Deoxycytidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D018450:Disease Progression; D006801:Humans; D017239:Paclitaxel / Q000008:administration & dosage / Q000009:adverse effects; D016019:Survival Analysis; D014571:Urologic Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000503:physiopathology; D000093542:Gemcitabine
chemical_list: D003841:Deoxycytidine; D017239:Paclitaxel; D002945:Cisplatin; D000093542:Gemcitabine