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

Koji Mitsuzuka, Shinichi Yamashita, Shunichi Namiki, Shigeyuki Yamada, Ko Sato, Hideo Saito, Yasuhiro Kaiho, Akihiro Ito, Haruo Nakagawa, Yoichi Arai

Research output: Contribution to journalArticle

3 Citations (Scopus)

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 1g/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 <60mL/min). The median number of cycles of low-dose maintenance chemotherapy was six (range 2-22), and the median survival time from initiation of first-line chemotherapy was 12 months (range 4-32 months). Adverse events requiring hospitalization were seen in three patients, but all of them recovered within a few days with conservative treatment. Seven patients discontinued within 9 months, whereas 10 patients continued on low-dose maintenance chemotherapy for ≥9 months. Patients with only lymph node metastases or who had a good response to previous first-line chemotherapy were likely to be able to continue low-dose maintenance chemotherapy. 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.

Original languageEnglish
Pages (from-to)1114-1119
Number of pages6
JournalInternational Journal of Urology
Volume21
Issue number11
DOIs
Publication statusPublished - 2014 Nov 1

Keywords

  • Adverse event
  • Carboplatin
  • Cisplatin-unfit
  • Low-dose maintenance chemotherapy
  • Urothelial carcinoma

ASJC Scopus subject areas

  • Urology

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