Combination Chemotherapy of Docetaxel, Ifosfamide and Cisplatin (DIP) in Patients with Metastatic Urothelial Cancer: a Preliminary Report

• Published in: Japanese journal of clinical oncology Vol. 35; no. 2; pp. 79 - 83
• Main Authors: Takahashi, Satoru, Suzuki, Makoto, Kume, Haruki, Matsumoto, Shinya, Okamoto, Naohiko, Nishimatsu, Hiroaki, Tomita, Kyoichi, Kitamura, Tadaichi
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01-02-2005; Oxford Publishing Limited (England)
• Subjects: Aged; Aged, 80 and over; Agranulocytosis - chemically induced; Anemia - chemically induced; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Bone Neoplasms - secondary; cisplatin; Cisplatin - administration & dosage; docetaxel; Drug Administration Schedule; Female; Humans; ifosfamide; Ifosfamide - administration & dosage; Lung Neoplasms - secondary; Lymphatic Metastasis; Male; metastatic urothelial cancer; Middle Aged; Soft Tissue Neoplasms - secondary; Taxoids - administration & dosage; Thrombocytopenia - chemically induced; Urologic Neoplasms - drug therapy; Urologic Neoplasms - pathology
• ISSN: 0368-2811; 1465-3621; 1465-3621
• DOI: 10.1093/jjco/hyi023

Objective: The aim of this study was to evaluate the efficacy and toxicity of a new combination chemotherapy of docetaxel, ifosfamide and cisplatin (DIP) in the treatment of metastatic urothelial cancer. Methods: Fourteen patients (nine male and five female; aged 59–82 years) with metastatic urothelial carcinoma, including five patients who have a history of methotrexate, vinblastine, doxorubicin and cisplatin (MVAC) chemotherapies, received the combination of docetaxel 60 mg/m2 on day 1, and ifosfamide 1.0 g/m2 and cisplatin 20 mg/m2 on days 2–6 and repeated every 21 days, to a maximum of six cycles. Eligibility criteria included performance status (World Health Organization) 0–3; normal bone marrow and liver function; and no symptomatic peripheral neuropathy. Results: Ten of the 14 patients (72%) demonstrated a partial response (PR), with durations of response ranging from 3 to 12 months [median 6.5 months; 95% confidence interval (CI), 4.1–8.7 months]. The response rate of the five patients with MVAC-refractory cancer was 80% with median duration of response 5.5 months, comparable with that of the cases without previous MVAC therapies. Grade 3–4 granulocytopenia occurred in 10 cases (71%), resulting in three episodes (21%) of febrile neutropenia. Grade 3 thrombocytopenia was observed in five cases (36%). No toxic death was observed. Grade 2 peripheral neuropathy was identified in one case. Conclusions: This pilot study demonstrated that DIP is an effective regimen for the treatment of metastatic urothelial cancer, and warrants further investigation.