Combination of gemcitabine and carboplatin as first line treatment in elderly patients or those unfit for cisplatin-based chemotherapy with advanced transitional cell carcinoma of the urinary tract

Joo Hee Park, Soon Wook Lee, Hye Sook Kim, Sung-Gu Kang, Young Hwii Ko, Seung Tae Kim, Seok Ho Kang, Young Je Park, In Keun Choi, Sang Cheul Oh, Deuk Jae Sung, Jae Hong Seo, Jun Cheon, Yeul Hong Kim, Jun Suk Kim, Kyong Hwa Park

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Abstract

Purpose: Although cisplatin-based chemotherapy is the standard of care for advanced transitional cell carcinoma, tolerability is a challenging issue in unfit patients. This study was conducted to evaluate the efficacy, toxicity, and tolerability of the combination of gemcitabine and carboplatin in unfit patients with advanced transitional cell carcinoma. Methods: Thirty-one patients who had advanced transitional cell carcinoma and one of the following clinical features were evaluated: Eastern Cooperative Oncology Group performance status equal or greater than 2, age older the 75 years or estimated glomerular filtration rate less than 60 ml/min. The patients were treated with carboplatin and gemcitabine delivered every 4 weeks. Results: Of the 31 patients, 71 % had an estimated glomerular filtration rate of less than 60 ml/min, and the remaining patients were treated by this protocol due to poor performance status or age older than 75. The median age of the patients was 74 years old. A total of 162 cycles of treatment were delivered to the patients. The overall response rate was 45.1 %. After the median follow-up of 15 months, the median progression-free survival time was 9.4 months (95 % CI 7.3-11.4) and overall survival time was 20 months (95 % CI 14.9-25.0). Grades 3 and 4 anemia, thrombocytopenia, and neutropenia were observed in 22.6, 6.45, and 6.45 % of patients, respectively. There was no treatment-related mortality in our patient series. Conclusion: The combination of gemcitabine and carboplatin is effective in elderly patients with advanced transitional cell carcinoma or those unfit for cisplatin-based chemotherapy, with manageable toxicity.

Original languageEnglish
Pages (from-to)1033-1039
Number of pages7
JournalCancer Chemotherapy and Pharmacology
Volume71
Issue number4
DOIs
Publication statusPublished - 2013 Apr 1

Fingerprint

gemcitabine
Chemotherapy
Transitional Cell Carcinoma
Carboplatin
Urinary Tract
Cisplatin
Cells
Drug Therapy
Toxicity
Oncology
Therapeutics
Glomerular Filtration Rate

Keywords

  • Chemotherapy
  • Elderly
  • Gemcitabine and carboplatin
  • Urothelial cell carcinoma

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Pharmacology
  • Pharmacology (medical)
  • Toxicology

Cite this

@article{060e3990c06645359ccaadf886858159,
title = "Combination of gemcitabine and carboplatin as first line treatment in elderly patients or those unfit for cisplatin-based chemotherapy with advanced transitional cell carcinoma of the urinary tract",
abstract = "Purpose: Although cisplatin-based chemotherapy is the standard of care for advanced transitional cell carcinoma, tolerability is a challenging issue in unfit patients. This study was conducted to evaluate the efficacy, toxicity, and tolerability of the combination of gemcitabine and carboplatin in unfit patients with advanced transitional cell carcinoma. Methods: Thirty-one patients who had advanced transitional cell carcinoma and one of the following clinical features were evaluated: Eastern Cooperative Oncology Group performance status equal or greater than 2, age older the 75 years or estimated glomerular filtration rate less than 60 ml/min. The patients were treated with carboplatin and gemcitabine delivered every 4 weeks. Results: Of the 31 patients, 71 {\%} had an estimated glomerular filtration rate of less than 60 ml/min, and the remaining patients were treated by this protocol due to poor performance status or age older than 75. The median age of the patients was 74 years old. A total of 162 cycles of treatment were delivered to the patients. The overall response rate was 45.1 {\%}. After the median follow-up of 15 months, the median progression-free survival time was 9.4 months (95 {\%} CI 7.3-11.4) and overall survival time was 20 months (95 {\%} CI 14.9-25.0). Grades 3 and 4 anemia, thrombocytopenia, and neutropenia were observed in 22.6, 6.45, and 6.45 {\%} of patients, respectively. There was no treatment-related mortality in our patient series. Conclusion: The combination of gemcitabine and carboplatin is effective in elderly patients with advanced transitional cell carcinoma or those unfit for cisplatin-based chemotherapy, with manageable toxicity.",
keywords = "Chemotherapy, Elderly, Gemcitabine and carboplatin, Urothelial cell carcinoma",
author = "Park, {Joo Hee} and Lee, {Soon Wook} and Kim, {Hye Sook} and Sung-Gu Kang and Ko, {Young Hwii} and Kim, {Seung Tae} and Kang, {Seok Ho} and Park, {Young Je} and Choi, {In Keun} and Oh, {Sang Cheul} and Sung, {Deuk Jae} and Seo, {Jae Hong} and Jun Cheon and Kim, {Yeul Hong} and Kim, {Jun Suk} and Park, {Kyong Hwa}",
year = "2013",
month = "4",
day = "1",
doi = "10.1007/s00280-013-2098-9",
language = "English",
volume = "71",
pages = "1033--1039",
journal = "Cancer Chemotherapy and Pharmacology",
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TY - JOUR

T1 - Combination of gemcitabine and carboplatin as first line treatment in elderly patients or those unfit for cisplatin-based chemotherapy with advanced transitional cell carcinoma of the urinary tract

AU - Park, Joo Hee

AU - Lee, Soon Wook

AU - Kim, Hye Sook

AU - Kang, Sung-Gu

AU - Ko, Young Hwii

AU - Kim, Seung Tae

AU - Kang, Seok Ho

AU - Park, Young Je

AU - Choi, In Keun

AU - Oh, Sang Cheul

AU - Sung, Deuk Jae

AU - Seo, Jae Hong

AU - Cheon, Jun

AU - Kim, Yeul Hong

AU - Kim, Jun Suk

AU - Park, Kyong Hwa

PY - 2013/4/1

Y1 - 2013/4/1

N2 - Purpose: Although cisplatin-based chemotherapy is the standard of care for advanced transitional cell carcinoma, tolerability is a challenging issue in unfit patients. This study was conducted to evaluate the efficacy, toxicity, and tolerability of the combination of gemcitabine and carboplatin in unfit patients with advanced transitional cell carcinoma. Methods: Thirty-one patients who had advanced transitional cell carcinoma and one of the following clinical features were evaluated: Eastern Cooperative Oncology Group performance status equal or greater than 2, age older the 75 years or estimated glomerular filtration rate less than 60 ml/min. The patients were treated with carboplatin and gemcitabine delivered every 4 weeks. Results: Of the 31 patients, 71 % had an estimated glomerular filtration rate of less than 60 ml/min, and the remaining patients were treated by this protocol due to poor performance status or age older than 75. The median age of the patients was 74 years old. A total of 162 cycles of treatment were delivered to the patients. The overall response rate was 45.1 %. After the median follow-up of 15 months, the median progression-free survival time was 9.4 months (95 % CI 7.3-11.4) and overall survival time was 20 months (95 % CI 14.9-25.0). Grades 3 and 4 anemia, thrombocytopenia, and neutropenia were observed in 22.6, 6.45, and 6.45 % of patients, respectively. There was no treatment-related mortality in our patient series. Conclusion: The combination of gemcitabine and carboplatin is effective in elderly patients with advanced transitional cell carcinoma or those unfit for cisplatin-based chemotherapy, with manageable toxicity.

AB - Purpose: Although cisplatin-based chemotherapy is the standard of care for advanced transitional cell carcinoma, tolerability is a challenging issue in unfit patients. This study was conducted to evaluate the efficacy, toxicity, and tolerability of the combination of gemcitabine and carboplatin in unfit patients with advanced transitional cell carcinoma. Methods: Thirty-one patients who had advanced transitional cell carcinoma and one of the following clinical features were evaluated: Eastern Cooperative Oncology Group performance status equal or greater than 2, age older the 75 years or estimated glomerular filtration rate less than 60 ml/min. The patients were treated with carboplatin and gemcitabine delivered every 4 weeks. Results: Of the 31 patients, 71 % had an estimated glomerular filtration rate of less than 60 ml/min, and the remaining patients were treated by this protocol due to poor performance status or age older than 75. The median age of the patients was 74 years old. A total of 162 cycles of treatment were delivered to the patients. The overall response rate was 45.1 %. After the median follow-up of 15 months, the median progression-free survival time was 9.4 months (95 % CI 7.3-11.4) and overall survival time was 20 months (95 % CI 14.9-25.0). Grades 3 and 4 anemia, thrombocytopenia, and neutropenia were observed in 22.6, 6.45, and 6.45 % of patients, respectively. There was no treatment-related mortality in our patient series. Conclusion: The combination of gemcitabine and carboplatin is effective in elderly patients with advanced transitional cell carcinoma or those unfit for cisplatin-based chemotherapy, with manageable toxicity.

KW - Chemotherapy

KW - Elderly

KW - Gemcitabine and carboplatin

KW - Urothelial cell carcinoma

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U2 - 10.1007/s00280-013-2098-9

DO - 10.1007/s00280-013-2098-9

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AN - SCOPUS:84878869135

VL - 71

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