title: Combining paclitaxel and lapatinib as second-line treatment for patients with metastatic transitional cell carcinoma: a case series.
abstract: BACKGROUND
  Current first-line cisplatin-based combination chemotherapy regimens provide interesting response rates but limited impact on survival for patients with metastatic transitional cell carcinoma of the urothelium. Such results leave a significant patient population in need of salvage therapy.
  
  
  METHODS
  As the epidermal growth factor receptors 1 and 2 (EGFR and HER2) are frequently overexpressed in urothelial carcinoma, we explored the feasibility of a combination of paclitaxel (80 mg/m(2)/week) and lapatinib (1,500 mg orally daily) for six patients who were treated after failure of first-line platinum-based chemotherapy.
  
  
  RESULTS
  Only one out of six patients was able to receive the full doses during the first six weeks of treatment, while grade 2 or 3 diarrhea events required lapatinib dose reduction (one patient) or discontinuation (five patients), despite loperamide support.
  
  
  CONCLUSIONS
  This combination is not recommended for this population of patients.
authors.affiliation: Department of Medical Oncology, Henri Mondor Hospital, Créteil, France. stephane.culine@sls.aphp.fr
authors.forename: Stéphane
authors.initials: S
authors.lastname: Culine
authors.forename: Zineb
authors.initials: Z
authors.lastname: Sellam
authors.forename: Linda
authors.initials: L
authors.lastname: Bouaita
authors.forename: Elias
authors.initials: E
authors.lastname: Assaf
authors.forename: Catherine
authors.initials: C
authors.lastname: Delbaldo
authors.forename: Muriel
authors.initials: M
authors.lastname: Verlinde-Carvalho
authors.forename: Damien
authors.initials: D
authors.lastname: Pouessel
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002295:Carcinoma, Transitional Cell / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D000077341:Lapatinib; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D017239:Paclitaxel / Q000008:administration & dosage / Q000009:adverse effects; D011799:Quinazolines / Q000008:administration & dosage / Q000009:adverse effects; D016879:Salvage Therapy; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy / Q000473:pathology; D014571:Urologic Neoplasms / Q000188:drug therapy* / Q000473:pathology
chemical_list: D011799:Quinazolines; D000077341:Lapatinib; D017239:Paclitaxel