You have accessJournal of UrologyUrothelial Cancer: Medical & Surgical Therapy1 Apr 2012535 SEQUENTIAL CHEMOTHERAPY WITH GEMCITABINE+CARBOPLATIN FOLLOWED BY GEMCITABINE+CARBOPLATIN+ DOCETAXEL FOR ADVANCED UPPER-TRACT UROTHELIAL CANCER Takahiro Yoneyama, Yuusuke Ishibashi, Teppei Okamoto, Yuuichirou Suzuki, Yuuki Tobisawa, Toru Yoneyama, Akiko Okamoto, Hayato Yamamoto, Atsushi Imai, Shingo Hatakeyama, Kazuyuki Mori, Yasuhiro Hashimoto, Takuya Koie, Noritaka Kamimura, and Chikara Ohyama Takahiro YoneyamaTakahiro Yoneyama Hirosaki, Japan More articles by this author , Yuusuke IshibashiYuusuke Ishibashi Hirosaki, Japan More articles by this author , Teppei OkamotoTeppei Okamoto Hirosaki, Japan More articles by this author , Yuuichirou SuzukiYuuichirou Suzuki Hirosaki, Japan More articles by this author , Yuuki TobisawaYuuki Tobisawa Hirosaki, Japan More articles by this author , Toru YoneyamaToru Yoneyama Hirosaki, Japan More articles by this author , Akiko OkamotoAkiko Okamoto Hirosaki, Japan More articles by this author , Hayato YamamotoHayato Yamamoto Hirosaki, Japan More articles by this author , Atsushi ImaiAtsushi Imai Hirosaki, Japan More articles by this author , Shingo HatakeyamaShingo Hatakeyama Hirosaki, Japan More articles by this author , Kazuyuki MoriKazuyuki Mori Hirosaki, Japan More articles by this author , Yasuhiro HashimotoYasuhiro Hashimoto Hirosaki, Japan More articles by this author , Takuya KoieTakuya Koie Hirosaki, Japan More articles by this author , Noritaka KamimuraNoritaka Kamimura Hirosaki, Japan More articles by this author , and Chikara OhyamaChikara Ohyama Hirosaki, Japan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.608AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Chemotherapy for advanced upper-tract urothelial cancer (UC) has not yet been established. Gemcitabine+cisplatin may be a promising regimen for advanced upper-tract UC as well as for advanced bladder cancer. However, cases with renal dysfunction are common in advanced upper-tract UC, and cisplatin often unfits for those patients. We retrospectively evaluated the effectiveness and adverse events (AEs) of a sequential chemotherapy with gemcitabine+carboplatin(GC) followed by GC+ docetaxel (GCD) for advanced upper-tract UC. METHODS We treated 47 patients (31 men and 16 women) with advanced upper-tract UC from September 2004 to December 2010. Mean age was 69.4 (43-89), and mean creatinine clearance was 45.0 (11.6-99.3) ml/minute. Mean observation period was 19.0 (3-51) months. There were 30 cases with recurrent disease after nephrouretectomy and 17 cases with unresectable tumor. The patients received 2 courses of GC consisted of 800mg/m2 gemcitabine on days 1, 8, and 15 and carboplatin (AUC 4) on day 2. If this regimen was effective, another 2 courses of GC was performed. If this regimen did not induce any tumor size reduction, we switched to 2 courses of GCD (70mg/m2) treatment as 2nd line treatment. RESULTS GC regimen yielded 3 cases (6.4%) of CR, 21 (44.7%) of PR, and the mean duration of response of 9.2 (2±38) months. PR was achieved in 3 (33.3%) of 9 M-VAC-resistant cases. GCD treatment was administered in 14 cases, and yielded two (14.3%) PR and a mean duration of response was 25.0 months. The median survival period was 14 months with GC/GCD regimens. Responder of GC therapy were longer survival period, significantly. As for ARs with GC regimen, there were 25 (53.2%) of G3/4 blood toxicity and 8 (17.0%) of G3/4 urticaria, but there were only 5 (10.6%) of G3/4 gastrointestinal AEs. In GCD regimen, there were 13 (100%) of blood toxicity and 7 (50.0%) of gastrointestinal AEs, and 1 (7.1%) of urticaria. There was no G3/4 renal toxicity in both regimens. CONCLUSIONS GC and GCD chemotherapy can be administered safely to advanced upper-tract UC cancer, many of whom have renal dysfunctions. GC regimen achieved high response rate (51.1%) in advanced upper-tract UC including M-VAC-resistant case. However, GCD had limited effectiveness for non-responder of GC. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e220 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Takahiro Yoneyama Hirosaki, Japan More articles by this author Yuusuke Ishibashi Hirosaki, Japan More articles by this author Teppei Okamoto Hirosaki, Japan More articles by this author Yuuichirou Suzuki Hirosaki, Japan More articles by this author Yuuki Tobisawa Hirosaki, Japan More articles by this author Toru Yoneyama Hirosaki, Japan More articles by this author Akiko Okamoto Hirosaki, Japan More articles by this author Hayato Yamamoto Hirosaki, Japan More articles by this author Atsushi Imai Hirosaki, Japan More articles by this author Shingo Hatakeyama Hirosaki, Japan More articles by this author Kazuyuki Mori Hirosaki, Japan More articles by this author Yasuhiro Hashimoto Hirosaki, Japan More articles by this author Takuya Koie Hirosaki, Japan More articles by this author Noritaka Kamimura Hirosaki, Japan More articles by this author Chikara Ohyama Hirosaki, Japan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...