The combination of paclitaxel and carboplatin as second-line chemotherapy can be a preferred regimen for patients with urothelial carcinoma after the failure of gemcitabine and cisplatin chemotherapy

  • Authors:
    • Nobuki Furubayashi
    • Takahito Negishi
    • Takuya Yamashita
    • Shuhei Kusano
    • Kenichi Taguchi
    • Mototsugu Shimokawa
    • Motonobu Nakamura
  • View Affiliations

  • Published online on: October 13, 2017     https://doi.org/10.3892/mco.2017.1452
  • Pages:1112-1118
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Abstract

There is no established standard second‑line chemotherapy after the failure of the first‑line cisplatin‑based chemotherapy for patients with advanced or metastatic urothelial carcinoma. With regards to second‑line chemotherapy, methotrexate, vinblastine, doxorubicin and cisplatin (MVAC) was used from July 2009 onwards, and paclitaxel and carboplatin (TC) was introduced in April 2014 at the National Kyushu Cancer Center. The present study aimed to assess the prognostic factors for overall survival (OS) in second‑line treatment that included best supportive care (BSC), and the tolerability and efficacy of TC chemotherapy. In total, 52 patients who were confirmed to have disease progression with first‑line gemcitabine and cisplatin (GC) between June 2009 and November 2016 were enrolled in the current study. In addition, 28 patients selected BSC as second‑line treatment, while 24 patients received second‑line chemotherapy (MVAC, n=8; TC, n=16). The median OS for BSC, MVAC and TC was 2.8, 5.4, and 12.7 months, respectively. The difference between BSC and MVAC was not statistically significant (P=0.596). However, the difference between BSC and TC was statistically significant after Bonferroni correction (P=0.002). Multivariate analyses revealed that anemia [hazard ratio (HR), 7.047; 95% confidence interval (CI), 1.553‑35.636; P=0.011], the presence of visceral metastasis (HR, 4.174; 95% CI, 1.506‑13.429; P=0.005) and second‑line treatment (TC HR, 0.296; 95% CI, 0.124‑0.636; P=0.003) were independent prognostic factors. TC achieved an 18.7% overall response rate and a 56.2% disease control rate. Myelosuppression was the most common grade ≥3 toxicity, but no treatment‑associated mortalities occurred during the study period. TC was associated with favorable benefits and safety, and may be considered a preferred regimen after the failure of GC.

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December 2017
Volume 7 Issue 6

Print ISSN: 2049-9450
Online ISSN:2049-9469

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APA
Furubayashi, N., Negishi, T., Yamashita, T., Kusano, S., Taguchi, K., Shimokawa, M., & Nakamura, M. (2017). The combination of paclitaxel and carboplatin as second-line chemotherapy can be a preferred regimen for patients with urothelial carcinoma after the failure of gemcitabine and cisplatin chemotherapy. Molecular and Clinical Oncology, 7, 1112-1118. https://doi.org/10.3892/mco.2017.1452
MLA
Furubayashi, N., Negishi, T., Yamashita, T., Kusano, S., Taguchi, K., Shimokawa, M., Nakamura, M."The combination of paclitaxel and carboplatin as second-line chemotherapy can be a preferred regimen for patients with urothelial carcinoma after the failure of gemcitabine and cisplatin chemotherapy". Molecular and Clinical Oncology 7.6 (2017): 1112-1118.
Chicago
Furubayashi, N., Negishi, T., Yamashita, T., Kusano, S., Taguchi, K., Shimokawa, M., Nakamura, M."The combination of paclitaxel and carboplatin as second-line chemotherapy can be a preferred regimen for patients with urothelial carcinoma after the failure of gemcitabine and cisplatin chemotherapy". Molecular and Clinical Oncology 7, no. 6 (2017): 1112-1118. https://doi.org/10.3892/mco.2017.1452