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Combination therapy with paclitaxel and gemcitabine after platinum‐based chemotherapy in patients with advanced urothelial cancer
Author(s) -
Harada Mirii,
Tomisaki Ikko,
Minato Akinori,
Onishi Rei,
Terado Michikazu,
Inatomi Hisato,
Fujimoto Naohiro
Publication year - 2021
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/iju.14616
Subject(s) - medicine , gemcitabine , oncology , tolerability , chemotherapy , paclitaxel , adverse effect , progression free survival
Objectives To evaluate the efficacy and tolerability of paclitaxel and gemcitabine therapy after platinum‐based chemotherapy for patients with advanced urothelial carcinoma. Methods Consecutive patients with advanced urothelial carcinoma who received paclitaxel and gemcitabine therapy from December 2003 to March 2018 were retrospectively reviewed. The objective response for paclitaxel and gemcitabine therapy, progression‐free survival and overall survival, and adverse events were evaluated. The reduction rate among each metastatic site and the associations between the clinical parameters and overall survival or progression‐free survival were also assessed. Results We enrolled 58 patients. Complete and partial responses were observed in two (3.4%) and 15 patients (26%), respectively. The median progression‐free survival and overall survival were 4.3 months (95% confidence interval 2.9–5.2) and 11.5 months (95% confidence interval 7.7–14.8), respectively. The objective response rates of primary site and metastases in lymph nodes, lung, bone, and liver were 6.0%, 37%, 23%, 0%, and 22%, respectively. Poor performance status (≥1), prior use of gemcitabine and the number of metastatic sites (≥2) were significantly associated with poor overall survival. Although three patients discontinued the treatment because of adverse events, there was no therapy‐related death. Conclusions Paclitaxel and gemcitabine therapy seems to be a valid option as a subsequent treatment after platinum‐based chemotherapy for urothelial carcinoma, especially in patients with favorable performance status and no prior use of gemcitabine.