title: Weekly paclitaxel and carboplatin against advanced transitional cell cancer after failure of a platinum-based regimen.
abstract: OBJECTIVE
  Weekly administration of paclitaxel plus carboplatin is hypothesized to be an effective second-line treatment for advanced transitional cell cancer after failure of platinum-based regimen. In this phase 2 trial, we tested this hypothesis.
  
  
  METHODS
  Patients with advanced transitional cell cancer who showed evidence of progressive or recurrent disease after methotrexate, vinblastine, doxorubicin, and cisplatin (MVAC) therapy were eligible for this study. Weekly paclitaxel (80mg/m(2)) and carboplatin (AUC 2) were administered on days 1, 8, 15, 22, 29, and 36; the cycle was repeated every 7 wk until disease progression or intolerable toxicity (maximum 18 doses).
  
  
  RESULTS
  Thirty-five patients entered this study. Among the 31 patients who were assessable, 10 had an objective response (overall response rate: 32.3%, 95% confidence interval, 15.8-48.7%). The median progression-free survival (PFS) and median survival times were 3.7 and 7.9 mo, respectively. Among the 22 patients who received prior MVAC therapy for metastatic disease, 36% had an objective response; their median PFS and median survival times were 4.3 and 7.9 mo, respectively; neither survival time significantly differed from the survival time of those who received prior MVAC as adjuvant setting. Toxicities were mild except one toxic death due to neutropenic sepsis.
  
  
  CONCLUSIONS
  Weekly paclitaxel plus carboplatin was a manageable, active second-line treatment for advanced transitional cell cancer after failure of platinum-based therapy.
authors: Medical Oncology Division, National Cancer Center Hospital, Tokyo, Japan. tkouno@ncc.go.jp
authors: Tsutomu
authors: T
authors: Kouno
authors: Masashi
authors: M
authors: Ando
authors: Kan
authors: K
authors: Yonemori
authors: Koji
authors: K
authors: Matsumoto
authors: Chikako
authors: C
authors: Shimizu
authors: Noriyuki
authors: N
authors: Katsumata
authors: Motokiyo
authors: M
authors: Komiyama
authors: Eijiro
authors: E
authors: Okajima
authors: Naoki
authors: N
authors: Matsuoka
authors: Hiroyuki
authors: H
authors: Fujimoto
authors: Yasuhiro
authors: Y
authors: Fujiwara
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use* / Q000633:toxicity; D016190:Carboplatin / Q000008:administration & dosage; D002295:Carcinoma, Transitional Cell / Q000188:drug therapy* / Q000401:mortality; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000401:mortality; D007682:Kidney Pelvis; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000008:administration & dosage; D018579:Patient Selection; D017671:Platinum Compounds / Q000627:therapeutic use; D016019:Survival Analysis; D017741:Survivors; D017211:Treatment Failure; D014523:Urethral Neoplasms / Q000188:drug therapy* / Q000401:mortality; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy* / Q000401:mortality
chemical_list: D017671:Platinum Compounds; D016190:Carboplatin; D017239:Paclitaxel