Phase II Trial of Gemcitabine Plus Cisplatin in Patients With Metastatic Urothelial Cancer

• Published in: Journal of clinical oncology Vol. 18; no. 9; pp. 1921 - 1927
• Main Authors: KAUFMAN, D, RAGHAVAN, D, CARDUCCI, M, LEVINE, E. G, MURPHY, B, AISNER, J, KUZEL, T, NICOL, S, OH, W, STADLER, W
• Format: Journal Article
• Language: English
• Published: Baltimore, MD American Society of Clinical Oncology 01-05-2000; Lippincott Williams & Wilkins
• Subjects: Adult; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; Carcinoma, Transitional Cell - drug therapy; Carcinoma, Transitional Cell - pathology; Cisplatin - administration & dosage; Deoxycytidine - administration & dosage; Deoxycytidine - analogs & derivatives; Female; Humans; Infusions, Intravenous; Male; Medical sciences; Middle Aged; Neoplasm Metastasis; Nephrology. Urinary tract diseases; Survival Analysis; Treatment Outcome; Tumors of the urinary system; Urinary tract. Prostate gland; Urologic Neoplasms - drug therapy; Urologic Neoplasms - pathology; Antineoplastic agent; Human; Urinary system disease; Gemcitabine; Indication; Toxicity; Treatment efficiency; Urinary tract disease; Metastasis; Malignant tumor; Urinary tract; Cisplatin; Chemotherapy; Phase II trial; Fluorine Organic compounds; Therapeutic protocol; Pyrimidine nucleoside; Platinum II Complexes
• ISSN: 0732-183X; 1527-7755
• DOI: 10.1200/JCO.2000.18.9.1921

To assess the activity and toxicity of the combination of gemcitabine and cisplatin in the treatment of chemotherapy-naive patients with metastatic urothelial cancer.
Forty-six patients with measurable stage IV carcinoma of the urothelium were enrolled onto this trial. Gemcitabine 1,000 mg/m(2) was administered intravenously for 30 to 60 minutes on days 1, 8, and 15 of each 28-day cycle. Cisplatin was administered after gemcitabine on day 1 of each cycle. The first 11 patients received an initial cisplatin dose of 100 mg/m(2). Due to the hematologic toxicity observed in several of these patients, the dose was reduced to 75 mg/m(2) in the remaining 35 patients. Patients were treated with six cycles, unless disease progression or severe toxicity necessitated earlier discontinuation.
Ten of the 46 patients achieved a complete response and nine showed a partial response. The overall response rate was 41%. The median time to treatment failure was 5.5 months. The median survival was 14.3 months, and the 1-year survival probability was 54%. Most of the toxicities were hematologic and, in general, easily manageable.
Gemcitabine plus cisplatin is active in the treatment of metastatic urothelial cancer in chemotherapy-naive patients and has an acceptable clinical safety profile. Studies are under way to further define the place of gemcitabine in combination with other chemotherapeutic agents in the treatment of metastatic urothelial cancer.