title: Long-term response in advanced bladder cancer involving the use of temsirolimus and vinflunine after platin resistance.
abstract: Relapse after initial first-line chemotherapy shows a poor prognosis in metastatic urothelial cancer. Currently, several chemotherapeutic agents and targeted drugs are under evaluation for platin-resistant advanced urothelial carcinoma. Vinflunine has been approved for second-line treatment in this indication. We present a patient with initial T4 advanced and subsequently metastasized bladder cancer, who has shown prolonged survival of 44 months after radical cystectomy. During her clinical course, the patient received two different platinum-containing therapies, temsirolimus within a phase II protocol and subsequent vinflunine chemotherapy. Treatment duration was 15 weeks with temsirolimus and 9 weeks with vinflunine, respectively, with a stable disease period of 3.8 months under temsirolimus therapy. This case is an example of how patients can derive a survival benefit from adequate sequencing of surgery and medical treatment including the newest therapies, even in advanced disease.
authors.affiliation: Department of Urology, Lukas Hospital, Neuss, Germany. holger.gerullis@gmx.net
authors.forename: Holger
authors.initials: H
authors.lastname: Gerullis
authors.forename: Thorsten Holger
authors.initials: TH
authors.lastname: Ecke
authors.forename: Barbara
authors.initials: B
authors.lastname: Janusch
authors.forename: Christian
authors.initials: C
authors.lastname: Arndt
authors.forename: Marcel
authors.initials: M
authors.lastname: Heidari
authors.forename: Jaba
authors.initials: J
authors.lastname: Oniani
authors.forename: Thomas
authors.initials: T
authors.lastname: Otto
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002295:Carcinoma, Transitional Cell / Q000188:drug therapy* / Q000601:surgery; D018450:Disease Progression; D005260:Female; D006801:Humans; D008875:Middle Aged; D020123:Sirolimus / Q000031:analogs & derivatives* / Q000627:therapeutic use; D013997:Time Factors; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000473:pathology; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D014747:Vinblastine / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D000970:Antineoplastic Agents; C111217:vinflunine; D014747:Vinblastine; C401859:temsirolimus; D020123:Sirolimus