Trastuzumab (Herceptin®) in patients with HER-2-overexpressing metastatic or locally advanced transitional cell carcinoma of the bladder: report on 7 patients

Abstract

Metastatic urothelial cancer is a rapidly fatal disease with a median survival of less than one year. Despite treatment with radical cystectomy in patients with advanced disease, approximatively 50–60% patients relapse with distant metastasic disease. Chemotherapy combining use of methotrexate, vinblastine, doxorubicin and cisplastin (M-VAC) has been considered to be the treatment of choice for patients with metastatic transitional cell carcinoma (TCC) of the bladder in many centers. 1 Ozen H. Bladder cancer. Curr Opin Oncol. 1999; 11: 207-212 Crossref PubMed Scopus (16) Google Scholar However, a number of recent regimens have been evaluated to improve efficacy and reduce toxicity of chemotherapy with encouraging results. A phase II study with the combination of carboplatin and paclitaxel reported a 72% objective response rate with mild to moderate toxicity in 32 patients suffering from advanced TCC. 2 Pycha A. Grbovic M. Posch B. et al. Paclitaxel and carboplatin in patients with metastatic transitional cell carcinoma of the urinary tract. Urology. 1999; 53: 510-515 Abstract Full Text Full Text PDF PubMed Scopus (44) Google Scholar More recently,the combination of cisplatin and gemcitabin has been shown to be an equally effective, but less toxic regimen in comparison to M-VAC in a large randomized study, establishing this treatment as a new standard of care in metastatic bladder cancer. 3 Von der Maase H. Sengelov L. Roberts J.T. et al. Long-term survival results of a randomized trial comparing gemcitabine plus cisplatin, with methotrexate, vinblastine, doxorubicin, plus cisplatin in patients with bladder cancer. J Clin Oncol. 2005; 23: 4602-4608 Crossref PubMed Scopus (1353) Google Scholar