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British Journal of Cancer logoLink to British Journal of Cancer
. 1998 Aug;78(3):370–374. doi: 10.1038/bjc.1998.501

Paclitaxel and carboplatin in patients with metastatic urothelial cancer: results of a phase II trial.

C C Zielinski 1, B Schnack 1, M Grbovic 1, T Brodowicz 1, C Wiltschke 1, G Steger 1, H Pflüger 1, M Marberger 1
PMCID: PMC2063028  PMID: 9703285

Abstract

The present phase II trial was undertaken to assess the efficacy and toxicity of a combination of paclitaxel and carboplatin as first-line chemotherapy in patients with metastatic transitional cell carcinoma of the urothelium. Twenty patients (age range 50-79 years; inclusion criteria: WHO performance status 0-2, no previous cytotoxic treatment) with metastatic transitional cell carcinoma of the urothelium were recruited and received cytotoxic treatment with paclitaxel at a dosage of 175 mg m(-2) administered over a 3-h infusion and carboplatin given at an AUC of 5 mg ml(-1) min (according to creatinine clearance) administered every 21 days. A total of 65% of patients achieved remissions (CR+PR), with CR occurring in 40% of patients. A further 15% of patients experienced stable disease. Remissions occurred after 2.4 +/- 0.8 (mean +/- standard deviation; range two to four) treatment cycles. The mean duration of responses (CR+PR) was 8.5 +/- 5.5 months. After a mean observation period of 11.4 +/- 4.8 months, 16 patients (80%) are alive. Toxicity included alopecia of WHO grade 3 in all patients, leucopenia of WHO grades 1 and 2 in ten patients, grade 3 in eight and grade 4 in two patients and, finally, severe thrombocytopenia grade 3 in only three patients. Non-haematological toxicity consisted of polyneuropathy of WHO grade 1 in 13 patients and grade 2 in five patients. We thus conclude that a combination of paclitaxel and carboplatin at the given dosage and schedule constitutes an active, well-tolerated first-line cytotoxic treatment for patients with metastatic urothelial cancer.

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Selected References

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  1. Boutan-Laroze A., Mahjoubi M., Droz J. P., Charrot P., Fargeot P., Kerbrat P., Caty A., Voisin P. M., Spielmann M., Rey A. M-VAC (methotrexate, vinblastine, doxorubicin and cisplatin) for advanced carcinoma of the bladder. The French Federation of Cancer Centers experience. Eur J Cancer. 1991;27(12):1690–1694. doi: 10.1016/0277-5379(91)90447-l. [DOI] [PubMed] [Google Scholar]
  2. Einhorn L. H., Roth B. J., Ansari R., Dreicer R., Gonin R., Loehrer P. J. Phase II trial of vinblastine, ifosfamide, and gallium combination chemotherapy in metastatic urothelial carcinoma. J Clin Oncol. 1994 Nov;12(11):2271–2276. doi: 10.1200/JCO.1994.12.11.2271. [DOI] [PubMed] [Google Scholar]
  3. Hillcoat B. L., Raghavan D., Matthews J., Kefford R., Yuen K., Woods R., Olver I., Bishop J., Pearson B., Coorey G. A randomized trial of cisplatin versus cisplatin plus methotrexate in advanced cancer of the urothelial tract. J Clin Oncol. 1989 Jun;7(6):706–709. doi: 10.1200/JCO.1989.7.6.706. [DOI] [PubMed] [Google Scholar]
  4. Igawa M., Ohkuchi T., Ueki T., Ueda M., Okada K., Usui T. Usefulness and limitations of methotrexate, vinblastine, doxorubicin and cisplatin for the treatment of advanced urothelial cancer. J Urol. 1990 Sep;144(3):662–665. doi: 10.1016/s0022-5347(17)39548-4. [DOI] [PubMed] [Google Scholar]
  5. Loehrer P. J., Sr, Einhorn L. H., Elson P. J., Crawford E. D., Kuebler P., Tannock I., Raghavan D., Stuart-Harris R., Sarosdy M. F., Lowe B. A. A randomized comparison of cisplatin alone or in combination with methotrexate, vinblastine, and doxorubicin in patients with metastatic urothelial carcinoma: a cooperative group study. J Clin Oncol. 1992 Jul;10(7):1066–1073. doi: 10.1200/JCO.1992.10.7.1066. [DOI] [PubMed] [Google Scholar]
  6. Logothetis C. J., Dexeus F. H., Finn L., Sella A., Amato R. J., Ayala A. G., Kilbourn R. G. A prospective randomized trial comparing MVAC and CISCA chemotherapy for patients with metastatic urothelial tumors. J Clin Oncol. 1990 Jun;8(6):1050–1055. doi: 10.1200/JCO.1990.8.6.1050. [DOI] [PubMed] [Google Scholar]
  7. Logothetis C. J., Dexeus F. H., Sella A., Amato R. J., Kilbourn R. G., Finn L., Gutterman J. U. Escalated therapy for refractory urothelial tumors: methotrexate-vinblastine-doxorubicin-cisplatin plus unglycosylated recombinant human granulocyte-macrophage colony-stimulating factor. J Natl Cancer Inst. 1990 Apr 18;82(8):667–672. doi: 10.1093/jnci/82.8.667. [DOI] [PubMed] [Google Scholar]
  8. Mottet Auselo N., Bons-Rosset F., Pellae-Cosset B., Costa P., Schwartz Y., Louis J. F., Navratil H. Le carboplatine et les tumeurs urothéliales: revue de la littérature. Bull Cancer. 1995 Mar;82(3):181–188. [PubMed] [Google Scholar]
  9. Pollera C. F., Ceribelli A., Crecco M., Calabresi F. Weekly gemcitabine in advanced bladder cancer: a preliminary report from a phase I study. Ann Oncol. 1994 Feb;5(2):182–184. doi: 10.1093/oxfordjournals.annonc.a058775. [DOI] [PubMed] [Google Scholar]
  10. Rangel C., Niell H., Miller A., Cox C. Taxol and taxotere in bladder cancer: in vitro activity and urine stability. Cancer Chemother Pharmacol. 1994;33(6):460–464. doi: 10.1007/BF00686501. [DOI] [PubMed] [Google Scholar]
  11. Roth B. J., Dreicer R., Einhorn L. H., Neuberg D., Johnson D. H., Smith J. L., Hudes G. R., Schultz S. M., Loehrer P. J. Significant activity of paclitaxel in advanced transitional-cell carcinoma of the urothelium: a phase II trial of the Eastern Cooperative Oncology Group. J Clin Oncol. 1994 Nov;12(11):2264–2270. doi: 10.1200/JCO.1994.12.11.2264. [DOI] [PubMed] [Google Scholar]
  12. Seidman A. D., Scher H. I., Gabrilove J. L., Bajorin D. F., Motzer R. J., O'Dell M., Curley T., Dershaw D. D., Quinlivan S., Tao Y. Dose-intensification of MVAC with recombinant granulocyte colony-stimulating factor as initial therapy in advanced urothelial cancer. J Clin Oncol. 1993 Mar;11(3):408–414. doi: 10.1200/JCO.1993.11.3.408. [DOI] [PubMed] [Google Scholar]
  13. Spencer C. M., Faulds D. Paclitaxel. A review of its pharmacodynamic and pharmacokinetic properties and therapeutic potential in the treatment of cancer. Drugs. 1994 Nov;48(5):794–847. doi: 10.2165/00003495-199448050-00009. [DOI] [PubMed] [Google Scholar]
  14. Sternberg C. N., Yagoda A., Scher H. I., Watson R. C., Ahmed T., Weiselberg L. R., Geller N., Hollander P. S., Herr H. W., Sogani P. C. Preliminary results of M-VAC (methotrexate, vinblastine, doxorubicin and cisplatin) for transitional cell carcinoma of the urothelium. J Urol. 1985 Mar;133(3):403–407. doi: 10.1016/s0022-5347(17)48996-8. [DOI] [PubMed] [Google Scholar]
  15. Sternberg C. N., Yagoda A., Scher H. I., Watson R. C., Geller N., Herr H. W., Morse M. J., Sogani P. C., Vaughan E. D., Bander N. Methotrexate, vinblastine, doxorubicin, and cisplatin for advanced transitional cell carcinoma of the urothelium. Efficacy and patterns of response and relapse. Cancer. 1989 Dec 15;64(12):2448–2458. doi: 10.1002/1097-0142(19891215)64:12<2448::aid-cncr2820641209>3.0.co;2-7. [DOI] [PubMed] [Google Scholar]
  16. Sternberg C. N., Yagoda A., Scher H. I., Watson R. C., Herr H. W., Morse M. J., Sogani P. C., Vaughan E. D., Jr, Bander N., Weiselberg L. R. M-VAC (methotrexate, vinblastine, doxorubicin and cisplatin) for advanced transitional cell carcinoma of the urothelium. J Urol. 1988 Mar;139(3):461–469. doi: 10.1016/s0022-5347(17)42494-3. [DOI] [PubMed] [Google Scholar]
  17. Tannock I., Gospodarowicz M., Connolly J., Jewett M. M-VAC (methotrexate, vinblastine, doxorubicin and cisplatin) chemotherapy for transitional cell carcinoma: the Princess Margaret Hospital experience. J Urol. 1989 Aug;142(2 Pt 1):289–292. doi: 10.1016/s0022-5347(17)38733-5. [DOI] [PubMed] [Google Scholar]
  18. Waxman J., Barton C. Carboplatin-based chemotherapy for bladder cancer. Cancer Treat Rev. 1993;19 (Suppl 100):21–25. doi: 10.1016/0305-7372(93)90044-r. [DOI] [PubMed] [Google Scholar]

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