title: Paclitaxel and cisplatin chemotherapy for metastatic urothelial carcinoma after failure of two courses of platinum-based regimens.
abstract: OBJECTIVE
  We investigated the outcomes of paclitaxel and cisplatin chemotherapy as an optional regimen for patients with metastatic urothelial carcinoma after failure of two consecutive platinum-based regimens.
  
  
  METHODS
  We retrospectively analyzed the data of 21 patients who had evidence of disease progression after two consecutive platinum-based regimens, gemcitabine and cisplatin (GC course), and methotrexate, vinblastine, doxorubicin and cisplatin (M-VAC course) as first-line and second-line treatments. As third-line chemotherapy, patients received paclitaxel (175 mg/m(2)) and cisplatin (70 mg/m(2)) every 3 weeks until disease progression.
  
  
  RESULTS
  Complete remission occurred in one patient (4.8%), partial remission occurred in three patients (14.3%) and stable disease occurred in five patients (23.8%). The overall response rate was 19.0% and the overall disease control rate, including stable disease, was 42.9%. The median progression-free survival (PFS) was 3 months (95% CI 3.0-5.0). The median overall survival was 9 months (95% CI 7.0-15.0). Grade 3 to 4 neutropenia appeared in 85.7% of patients. No life-threatening complications were observed.
  
  
  CONCLUSIONS
  Paclitaxel and cisplatin chemotherapy could be an optional regimen for patients with metastatic urothelial carcinoma after the failure of two consecutive standard platinum-based regimens.
authors.affiliation: Center for Prostate Cancer, National Cancer Center, Goyang, Korea.
authors.forename: Jae Young
authors.initials: JY
authors.lastname: Joung
authors.forename: Whi-An
authors.initials: WA
authors.lastname: Kwon
authors.forename: In-Chang
authors.initials: IC
authors.lastname: Cho
authors.forename: Eun Kyung
authors.initials: EK
authors.lastname: Kim
authors.forename: Sohee
authors.initials: S
authors.lastname: Park
authors.forename: Hyekyoung
authors.initials: H
authors.lastname: Yoon
authors.forename: Ho Kyung
authors.initials: HK
authors.lastname: Seo
authors.forename: Jinsoo
authors.initials: J
authors.lastname: Chung
authors.forename: Weon Seo
authors.initials: WS
authors.lastname: Park
authors.forename: Kang Hyun
authors.initials: KH
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002277:Carcinoma / Q000188:drug therapy* / Q000473:pathology / Q000556:secondary*; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D005839:Gentamicins / Q000008:administration & dosage; D006801:Humans; D053208:Kaplan-Meier Estimate; D007680:Kidney Neoplasms / Q000188:drug therapy / Q000473:pathology; D008175:Lung Neoplasms / Q000188:drug therapy / Q000556:secondary; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged; D017239:Paclitaxel / Q000008:administration & dosage / Q000009:adverse effects; D012189:Retrospective Studies; D017211:Treatment Failure; D014516:Ureteral Neoplasms / Q000188:drug therapy / Q000473:pathology; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy* / Q000473:pathology; D019459:Urothelium / Q000473:pathology; D014747:Vinblastine / Q000008:administration & dosage
chemical_list: D005839:Gentamicins; D014747:Vinblastine; D004317:Doxorubicin; D017239:Paclitaxel; D002945:Cisplatin; D008727:Methotrexate