Taxotere and gemcitabine for bladder cancer – pro
A variety of therapeutic options are available to patients with metastatic bladder cancer. More recently, gemcitabine and cisplatin was found to be as effective and less toxic than MIAD, but the cisplatin still produces much toxicity. Gemcitabin and docetaxel has been studied in an attempt to minimize toxicity; it showed response rates of 40%–60%. In a phase ii trial of the same regimen in a weekly schedule, a cr of 42% (mds: 11.9 months) was achieved, but the excitement with these results was damped by the high level of associated pulmonary toxicity (including 1 death) . Furthermore, a regimen consisting of docetaxel and gemcitabine showed promising response rates of 30%–50% and median OS times of 13–15 months in phase ii trials. It is an acceptable regimen per NCCN. It recommends the following for first line therapy:
NCCN.ORG, Bladder cancer BG,2, 2014
Manola JB, Dreicer R, Wilding G. Gemcitabine and docetaxel in advanced carcinoma of the urothelium: report of a phase II Eastern Cooperative Oncology Group trial. Program and abstracts of the American Society of Clinical Oncology 38th Annual Meeting, May 18-21, 2002; Orlando, Florida. Abstract 796
F.A. Yafi, MD, S. North, MD, and W. Kassouf, MD. First- and second-line therapy for metastatic urothelial carcinoma of the bladder
Dreicer R, Manola J, Schneider DJ, Schwerkoske JF, George CS, Roth BJ, Wilding G; Eastern Cooperative Oncology Group. Phase II trial of gemcitabine and docetaxel in patients with advanced carcinoma of the urothelium: a trial of the Eastern Cooperative Oncology Group.Cancer. 2003 Jun 1;97(11):2743-7. Galsky, Matthew D. The Role of Taxanes in the Management of Bladder Cancer Oncologist 2005 10: 792-798
Galsky, Matthew D.
The Role of Taxanes in the Management of Bladder Cancer
Oncologist 2005 10: 792-798
Less is known about how to deal with recurrent metastatic disease. NCCN says: “No standard therapy exists in this setting. Options include single agent therapy with a taxane or premetrexed…”.In one trial, docetaxel and gemcitabine combination therapy in patients with progressing regional or metastatic transitional cell carcinoma who had failed a prior chemotherapy treatment. Five patients obtained an objective response for an overall response rate of 17% (90% confidence interval, 7-33%). One patient achieved a complete clinical response. The median overall survival of the group was 7.7 months .The authors concluded that for patients who have failed a previous chemotherapy regimen, this gemcitabine-docetaxel combination may be a useful alternative; however, it was obviously not a very active regimen.
NCCN.ORG, Bladder Cancer, BG-2, 2014
Manola JB, Dreicer R, Wilding G. Gemcitabine and docetaxel in advanced carcinoma of the urothelium: report of a phase II Eastern Cooperative Oncology Group trial. Program and abstracts of the American Society of Clinical Oncology 38th Annual Meeting, May 18-21, 2002; Orlando, Florida. Abstract 796
Dreicer R, Manola J, Schneider DJ, Schwerkoske JF, George CS, Roth BJ, Wilding G; Eastern Cooperative Oncology Group. Phase II trial of gemcitabine and docetaxel in patients with advanced carcinoma of the urothelium: a trial of the Eastern Cooperative Oncology Group.Cancer. 2003 Jun 1;97(11):2743-7. Galsky, Matthew D. The Role of Taxanes in the Management of Bladder Cancer Oncologist 2005 10: 792-798
Galsky, Matthew D.
The Role of Taxanes in the Management of Bladder Cancer
Oncologist 2005 10: 792-798