Efficacy and Toxicity of Gemcitabine Based Chemotherapy for Advanced Urothelial Cancer

Yoon, Dong Jin; Chang, Sung Goo

Abstract

PURPOSE
To evaluate the response and toxicity of gemcitabine and cisplatin combination chemotherapy in advanced transitional cell carcinomas.
MATERIALS AND METHODS
Twenty two patients with advanced transitional cell carcinoma received gemcitabine combined chemotherapy. Nineteen of them were scheduled to receive 1,000mg/m2 gemcitabine intravenously for 30 minutes on days 1, 8, and 15 and 70mg/m2 cisplatin for 1 hour on day 1 of a 28-day cycle. In addition, 3 patients with decreased renal function were scheduled to receive 1,200mg/m2 gemcitabine on day 1, 8, and 15. The toxicity of each cycle and the response after more than 4 cycles were evaluated.
RESULTS
There were 5 complete responses and 4 partial responses in the 15 assessable patients, giving an overall response rate 60%. The toxicity was primarily hematologic, with 3 out of 22 patients (14%) with grade 3 thrombocytopenia, 10 out of 22 patients (45%) with grade 1 & 2 leukopenia and 10 out of 22 patients (45%) having grade 1 & 2 anemia. The most common non-hematologic toxic response was nausea and vomiting.
CONCLUSIONS
Gemcitabine based chemotherapy for advanced transitional cell carcinoma has larger response rate compared to M-VAC. Furthermore, it has much less systemic toxicity than M-VAC combination chemotherapy.