The efficacy and safety of pemetrexed and nedaplatin in salvage chemotherapy of advanced urinary carcinoma

Abstract

Objective To evaluate the efficacy and toxicity of pemetrexed and nedaplatin in the treatment of patients with locally advanced or metastatic urothelial cell carcinoma who failed a first-line GC regimen. Methods A total of 11 patients with locally advanced or metastatic urothelial carcinoma failed with first-line treatment of GC regimen were included in the present study. There were 6 males and 5 females, aged 56-80 years old, median age was 65 years old. Six patients′ primary tumors were in bladder, 4 in the renal pelvis, 1 ureter. There were 7 cases with ECOG score 0 point, 3 cases 1 point, 1 case 2 points. Patients received pemetrexed 500 mg/m2 intravenously on the 1st day, and nedaplatin 25mg/m2 from the 1st to 3th day every 21 days. The evaluation of efficacy and adverse reactions were carried out after 2 to 3 cycles. Results Eleven patients received 1 to 6 cycles (mean 3.3 cycles) treatments. There were 2 cases (18.2%) complete remission, 5 cases (45.5%) partial remission, 2 cases (18.2%) no change and 2 cases (18.2%) progressed. The total effective rate was 63.6%. The main adverse events were anemia (6 cases), leukopenia (5 cases), nausea and vomiting (6 cases) and rash (5 cases) , all of which were mild to moderate. No treatment-related death occurred. Conclusions Pemetrexed and nedaplatin regimen could be effective in the treatment of advanced urothelial carcinoma after first-line chemotherapy failed. The side effect is mild. Key words: Urothelial carcinoma; Pemetrex; Second-line therapy