“…18 Considering the low response rate of paclitaxel alone when used as a second-line treatment, its combination with gemcitabine, cisplatin, carboplatin and ifosfamide have been investigated , and the response rate increased to 15-40%. 1,[9][10][11][12][13]18,19 In the present study, the response rate was 19.0% and overall disease control rate was 42.9%. Our response rate is low when compared with second-line treatments.…”
Section: Discussionmentioning
confidence: 72%
“…We encountered neuropathy in 10 patients (43.5%), which was comparable to the results in second-line studies. 1,10,11,13,20,21 Grade 3 neuropathy appeared in just two patients (9.5%) and they needed no additional treatments.…”
Section: Discussionmentioning
confidence: 96%
“…1,10,11,13,20,21 Grade 4 neutropenia occurred in 13 (61.9%) patients. Seven (53.8%) of 13 patients with grade 4 neutropenia had never experienced neutropenia higher than grade 3 during the first-line or second-line treatments (data not shown).…”
Section: Discussionmentioning
confidence: 99%
“…For previous chemotherapy, 18 patients received the GC regimen as the first-line and the M-VAC regimen as the second-line treatments, and three patients received M-VAC as the first-line and GC as the second-line treatments. The median treatment-free interval was 3.5 months (range [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. The response rate including complete remission (CR) and PR of the previous two regimens was 38.1%.…”
Section: Patient Characteristicsmentioning
confidence: 99%
“…It has been used with gemcitabine, ifosfamide carboplatin, and cisplatin in first-line or secondline therapies. 1,[9][10][11][12][13] We can assume that metastatic urothelial carcinoma, even after platinum-based chemotherapy, still consists of heterogeneous components including platinumsensitive and platinum-resistant tumors. We hypothesized that a combination of cisplatin and paclitaxel could induce better responses in patients with metastatic urothelial carcinoma.…”
Objectives: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.
“…18 Considering the low response rate of paclitaxel alone when used as a second-line treatment, its combination with gemcitabine, cisplatin, carboplatin and ifosfamide have been investigated , and the response rate increased to 15-40%. 1,[9][10][11][12][13]18,19 In the present study, the response rate was 19.0% and overall disease control rate was 42.9%. Our response rate is low when compared with second-line treatments.…”
Section: Discussionmentioning
confidence: 72%
“…We encountered neuropathy in 10 patients (43.5%), which was comparable to the results in second-line studies. 1,10,11,13,20,21 Grade 3 neuropathy appeared in just two patients (9.5%) and they needed no additional treatments.…”
Section: Discussionmentioning
confidence: 96%
“…1,10,11,13,20,21 Grade 4 neutropenia occurred in 13 (61.9%) patients. Seven (53.8%) of 13 patients with grade 4 neutropenia had never experienced neutropenia higher than grade 3 during the first-line or second-line treatments (data not shown).…”
Section: Discussionmentioning
confidence: 99%
“…For previous chemotherapy, 18 patients received the GC regimen as the first-line and the M-VAC regimen as the second-line treatments, and three patients received M-VAC as the first-line and GC as the second-line treatments. The median treatment-free interval was 3.5 months (range [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. The response rate including complete remission (CR) and PR of the previous two regimens was 38.1%.…”
Section: Patient Characteristicsmentioning
confidence: 99%
“…It has been used with gemcitabine, ifosfamide carboplatin, and cisplatin in first-line or secondline therapies. 1,[9][10][11][12][13] We can assume that metastatic urothelial carcinoma, even after platinum-based chemotherapy, still consists of heterogeneous components including platinumsensitive and platinum-resistant tumors. We hypothesized that a combination of cisplatin and paclitaxel could induce better responses in patients with metastatic urothelial carcinoma.…”
Objectives: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.
BACKGROUND:To the authors' knowledge, no previous studies have been reported with the combination of paclitaxel and oral cyclophosphamide in patients with metastatic bladder cancer. A phase 1/2 study was
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