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Methotrexate‐paclitaxel‐epirubicin‐carboplatin as second‐line chemotherapy in patients with metastatic transitional cell carcinoma of the bladder pretreated with cisplatin‐gemcitabine: A phase II study
Author(s) -
Halim Amal,
Abotouk Niveen
Publication year - 2013
Publication title -
asia‐pacific journal of clinical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 29
eISSN - 1743-7563
pISSN - 1743-7555
DOI - 10.1111/j.1743-7563.2012.01554.x
Subject(s) - epirubicin , gemcitabine , medicine , carboplatin , chemotherapy , cisplatin , neutropenia , oncology , urology , toxicity , paclitaxel , methotrexate , antimetabolite , gastroenterology , cyclophosphamide
Aims To assess the efficacy and toxicity of methotrexate‐paclitaxel‐epirubicin‐carboplatin combination as second‐line chemotherapy in patients with metastatic transitional cell carcinoma ( TCC ) of the bladder pretreated with cisplatin‐gemcitabine. Methods In this prospective phase II study, patients with metastatic TCC of the bladder pretreated with first‐line cisplatin‐gemcitabine received on progression paclitaxel 175 mg/m 2 i.v. and carboplatin (area under curve of 5) on day 1, and methotrexate 40 mg/m 2 and epirubicin 40 mg/m 2 on day 15. The whole course was repeated every 28 days. The end‐points included clinical tumor response, treatment toxicity, quality of life and survival. Results A total of 40, predominantly male, patients were enrolled (median age 62 years [range 46–69]). Efficacy and survival were assessed in 38 patients only, as two patients refused treatment after the first cycle. Grade 3 neutropenia was the commonest acute severe toxicity (12/40 patients; 30%). The overall response rate was 39% (15/38 patients). The median follow up was 14 months (range 3–45). The median progression‐free and overall survival were 12 and 12.5 months, respectively. The 1‐year progression‐free and overall survival were 24 and 35%, respectively. Conclusion Methotrexate‐paclitaxel‐epirubicin‐carboplatin combination as second‐line chemotherapy in patients with metastatic TCC of the bladder results in a modest response rate with acceptable toxicity.