LOW DOSE MAINTENANCE CHEMOTHERAPY FOR METASTATIC UROTHELIAL CANCER

Int J Urol. 2014 Jun 24. doi: 10.1111/iju.12532. [Epub ahead of print]

Low-dose maintenance gemcitabine-carboplatin chemotherapy could be an alternative to continuous standard chemotherapy for patients with metastatic urothelial carcinoma.

Mitsuzuka K1, Yamashita S, Namiki S, Yamada S, Sato K, Saito H, Kaiho Y, Ito A, Nakagawa H, Arai Y.

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Abstract

OBJECTIVES:

To examine whether low-dose maintenance gemcitabine-carboplatin chemotherapy is beneficial for patients with metastatic urothelial carcinoma.

METHODS:

We retrospectively reviewed the records of 36 patients with metastatic urothelial carcinoma who received first-line chemotherapy (gemcitabine/cisplatin, gemcitabine/carboplatin, or methotrexate/vinblastine/adriamycin/cisplatin) between 2006 and 2012. Those who had responded, but were unable to tolerate ongoing first-line chemotherapy, had been switched to low-dose maintenance chemotherapy consisting of 1 g/m2 of gemcitabine and area under the curve 2-4 of carboplatin given on day 1 of a 6-week cycle, and were continued unless disease progression was seen.

RESULTS:

After a median of three cycles of first-line chemotherapy, 17 patients had been switched to low-dose maintenance chemotherapy. The median age was 70 years (range 56-79 years), and 12 patients (70.6%) had renal dysfunction (creatinine clearance <60 10="" 12="" 2-22="" 4-32="" 9="" a="" able="" adverse="" all="" and="" be="" but="" chemotherapy.="" chemotherapy="" conservative="" continue="" continued="" cycles="" days="" discontinued="" events="" few="" first-line="" for="" from="" good="" had="" hospitalization="" in="" initiation="" likely="" low-dose="" lymph="" maintenance="" median="" metastases="" min="" ml="" months.="" months="" node="" number="" of="" on="" only="" or="" p="" patients="" previous="" range="" recovered="" requiring="" response="" seen="" seven="" six="" survival="" the="" them="" three="" time="" to="" treatment.="" was="" were="" whereas="" who="" with="" within="">

CONCLUSIONS:

Low-dose maintenance gemcitabine-carboplatin chemotherapy might represent an alternative for patients with metastatic urothelial carcinoma not tolerating continuous first-line standard chemotherapy regimens.