%0 Journal Article
%T Triplet chemotherapy with paclitaxel, gemcitabine, and cisplatin as second-line therapy for advanced urothelial carcinoma
%A Hideki Takeshita
%A Koji Chiba
%A Sachi Kitayama
%A Shingo Moriyama
%A Rika Omura
%A Akira Noro
%J Modern Chemotherapy
%P 1-7
%@ 2169-3498
%D 2013
%I Scientific Research Publishing
%R 10.4236/mc.2013.21001
%X <span style=\"font-family:'Arial','sans-serif';font-size:10pt;\">Background: Methotrexate, vinblastine, doxorubicin, and cisplatin regimen, and gemcitabine and cisplatin regimen are widely used for ad<span>vanced or metastatic urothelial carcinomas (UCs). However, a </span>standard treatment for patients who fail these firstline chemotherapies is unavailable. We examined the efficacy and safety of secondline paclitaxel, gemcitabine, and cisplatin (PCG) chemotherapy in Japanese patients. Methods: Between 2004 and 2010, 25 patients with metastatic UCs who failed to respond to platinumbased regimens were treated with PCG. They received intravenous paclitaxel (60 mg/m<sup>2</sup>) and gemcitabine (1000 mg/m<sup>2</sup>) on days 1 and 8, and cisplatin (70 mg/m<sup>2</sup>) on day 2 of every 21 day course. We retrospectively collected patients¡¯ clinical and pathological data and evaluated adverse effects and survivals. Results: Patients underwent 95 PCG cycles in all (average, 3.8 cycles per patient). One patient (4%) achieved complete response, 5 (20%) showed partial response, 8 (42%) had disease stabilization, and 5 (26%) had disease progression. Median overall survival was 8.5 months. Neutropenia and thrombocytopenia of grade ¡İ 3 were observed in 68% and 56% of patients, respectively. No treatment related death occurred. Multivariate analysis revealed that hemoglobin levels &lt; 10 g/dL and estimated glomerular filtration rate &lt; 60 mL/(min</span><span style=\"font-family:'Arial','sans-serif';font-size:10pt;\">1.73 m<sup>2</sup></span><span style=\"font-family:'Arial','sans-serif';font-size:10pt;\">) were significant risk factors for overall survival. Conclusion: PCG chemotherapy in the secondline setting potentially contributed to good prognosis in selected patients with relatively significant but tolerable toxicity.</span>
%K Metastatic Urothelial Carcinoma
%K Second-Line
%K Paclitaxel
%K Gemcitabine
%U http://www.scirp.org/journal/PaperInformation.aspx?PaperID=27565