Modified MVAC as a second-line treatment for patients with metastatic urothelial carcinoma after failure of gemcitabine and cisplatin treatment

Jung Hyun Lee, Sung-Gu Kang, Seung Tae Kim, Seok Ho Kang, In Keun Choi, Young Je Park, Sang Cheul Oh, Deuk Jae Sung, Jae Hong Seo, Jun Cheon, Sang Won Shin, Yeul Hong Kim, Jun Suk Kim, Kyong Hwa Park

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6 Citations (Scopus)

Abstract

Purpose There is no established standard second-line chemotherapy for patients with advanced or metastatic urothelial carcinoma (UC) who failed gemcitabine and cisplatin (GC) chemotherapy. This study was conducted in order to investigate the efficacy and toxicity of modified methotrexate, vinblastine, doxorubicin, and cisplatin (MVAC) in patients with metastatic UC previously treated with GC. Materials and Methods We retrospectively analyzed 28 patients who received modified MVAC between November 2004 and November 2012. All patients failed prior, first-line GC chemotherapy. Results The median age of patients was 64.0 years (range, 33.0 to 77.0 years), and 23 (82.1%) patients had an Eastern Cooperative Oncology Group performance status of 0 or 1. The overall response rate and the disease control rate were 36.0% and 64.0%, respectively. After a median follow-up period of 38 weeks (range, 5 to 182 weeks), median progression free survival was 21.0 weeks (95% confidence interval [CI], 6.3 to 35.7 weeks) and median overall survival was 49.0 weeks (95% CI, 18.8 to 79.3 weeks). Grade 3 or 4 hematological toxicities included neutropenia (n=21, 75.0%) and anemia (n=9, 32.1%). Grade 3 or 4 non-hematological toxicities did not occur and there was no treatment-related death. Conclusion Modified MVAC appears to be a safe and active chemotherapy regimen in patients with stable physical status and adequate renal function after GC treatment.

Original languageEnglish
Pages (from-to)172-177
Number of pages6
JournalCancer Research and Treatment
Volume46
Issue number2
DOIs
Publication statusPublished - 2014 Jan 1

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gemcitabine
Vinblastine
Methotrexate
Doxorubicin
Cisplatin
Carcinoma
Drug Therapy
Therapeutics
Confidence Intervals
Neutropenia
Disease-Free Survival
Anemia

Keywords

  • Cisplatin failure
  • M-VAC protocol
  • Second-line
  • Urothelial carcinoma

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

@article{3964cdc2d930497e9faadcc6849f861d,
title = "Modified MVAC as a second-line treatment for patients with metastatic urothelial carcinoma after failure of gemcitabine and cisplatin treatment",
abstract = "Purpose There is no established standard second-line chemotherapy for patients with advanced or metastatic urothelial carcinoma (UC) who failed gemcitabine and cisplatin (GC) chemotherapy. This study was conducted in order to investigate the efficacy and toxicity of modified methotrexate, vinblastine, doxorubicin, and cisplatin (MVAC) in patients with metastatic UC previously treated with GC. Materials and Methods We retrospectively analyzed 28 patients who received modified MVAC between November 2004 and November 2012. All patients failed prior, first-line GC chemotherapy. Results The median age of patients was 64.0 years (range, 33.0 to 77.0 years), and 23 (82.1{\%}) patients had an Eastern Cooperative Oncology Group performance status of 0 or 1. The overall response rate and the disease control rate were 36.0{\%} and 64.0{\%}, respectively. After a median follow-up period of 38 weeks (range, 5 to 182 weeks), median progression free survival was 21.0 weeks (95{\%} confidence interval [CI], 6.3 to 35.7 weeks) and median overall survival was 49.0 weeks (95{\%} CI, 18.8 to 79.3 weeks). Grade 3 or 4 hematological toxicities included neutropenia (n=21, 75.0{\%}) and anemia (n=9, 32.1{\%}). Grade 3 or 4 non-hematological toxicities did not occur and there was no treatment-related death. Conclusion Modified MVAC appears to be a safe and active chemotherapy regimen in patients with stable physical status and adequate renal function after GC treatment.",
keywords = "Cisplatin failure, M-VAC protocol, Second-line, Urothelial carcinoma",
author = "Lee, {Jung Hyun} and Sung-Gu Kang and Kim, {Seung Tae} and Kang, {Seok Ho} and Choi, {In Keun} and Park, {Young Je} and Oh, {Sang Cheul} and Sung, {Deuk Jae} and Seo, {Jae Hong} and Jun Cheon and Shin, {Sang Won} and Kim, {Yeul Hong} and Kim, {Jun Suk} and Park, {Kyong Hwa}",
year = "2014",
month = "1",
day = "1",
doi = "10.4143/crt.2014.46.2.172",
language = "English",
volume = "46",
pages = "172--177",
journal = "Cancer Research and Treatment",
issn = "1598-2998",
publisher = "Korean Society for Thoracic and Cardiovascular Surgery",
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}

TY - JOUR

T1 - Modified MVAC as a second-line treatment for patients with metastatic urothelial carcinoma after failure of gemcitabine and cisplatin treatment

AU - Lee, Jung Hyun

AU - Kang, Sung-Gu

AU - Kim, Seung Tae

AU - Kang, Seok Ho

AU - Choi, In Keun

AU - Park, Young Je

AU - Oh, Sang Cheul

AU - Sung, Deuk Jae

AU - Seo, Jae Hong

AU - Cheon, Jun

AU - Shin, Sang Won

AU - Kim, Yeul Hong

AU - Kim, Jun Suk

AU - Park, Kyong Hwa

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Purpose There is no established standard second-line chemotherapy for patients with advanced or metastatic urothelial carcinoma (UC) who failed gemcitabine and cisplatin (GC) chemotherapy. This study was conducted in order to investigate the efficacy and toxicity of modified methotrexate, vinblastine, doxorubicin, and cisplatin (MVAC) in patients with metastatic UC previously treated with GC. Materials and Methods We retrospectively analyzed 28 patients who received modified MVAC between November 2004 and November 2012. All patients failed prior, first-line GC chemotherapy. Results The median age of patients was 64.0 years (range, 33.0 to 77.0 years), and 23 (82.1%) patients had an Eastern Cooperative Oncology Group performance status of 0 or 1. The overall response rate and the disease control rate were 36.0% and 64.0%, respectively. After a median follow-up period of 38 weeks (range, 5 to 182 weeks), median progression free survival was 21.0 weeks (95% confidence interval [CI], 6.3 to 35.7 weeks) and median overall survival was 49.0 weeks (95% CI, 18.8 to 79.3 weeks). Grade 3 or 4 hematological toxicities included neutropenia (n=21, 75.0%) and anemia (n=9, 32.1%). Grade 3 or 4 non-hematological toxicities did not occur and there was no treatment-related death. Conclusion Modified MVAC appears to be a safe and active chemotherapy regimen in patients with stable physical status and adequate renal function after GC treatment.

AB - Purpose There is no established standard second-line chemotherapy for patients with advanced or metastatic urothelial carcinoma (UC) who failed gemcitabine and cisplatin (GC) chemotherapy. This study was conducted in order to investigate the efficacy and toxicity of modified methotrexate, vinblastine, doxorubicin, and cisplatin (MVAC) in patients with metastatic UC previously treated with GC. Materials and Methods We retrospectively analyzed 28 patients who received modified MVAC between November 2004 and November 2012. All patients failed prior, first-line GC chemotherapy. Results The median age of patients was 64.0 years (range, 33.0 to 77.0 years), and 23 (82.1%) patients had an Eastern Cooperative Oncology Group performance status of 0 or 1. The overall response rate and the disease control rate were 36.0% and 64.0%, respectively. After a median follow-up period of 38 weeks (range, 5 to 182 weeks), median progression free survival was 21.0 weeks (95% confidence interval [CI], 6.3 to 35.7 weeks) and median overall survival was 49.0 weeks (95% CI, 18.8 to 79.3 weeks). Grade 3 or 4 hematological toxicities included neutropenia (n=21, 75.0%) and anemia (n=9, 32.1%). Grade 3 or 4 non-hematological toxicities did not occur and there was no treatment-related death. Conclusion Modified MVAC appears to be a safe and active chemotherapy regimen in patients with stable physical status and adequate renal function after GC treatment.

KW - Cisplatin failure

KW - M-VAC protocol

KW - Second-line

KW - Urothelial carcinoma

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U2 - 10.4143/crt.2014.46.2.172

DO - 10.4143/crt.2014.46.2.172

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JO - Cancer Research and Treatment

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