Gemcitabine Plus Vinorelbine Chemotherapy in Patients with Advanced Bladder Carcinoma Who Are Medically Unsuitable for or Who Have Failed Cisplatin-Based Chemotherapy

• Published in: European urology Vol. 44; no. 6; pp. 682 - 686
• Main Authors: Türkölmez, Kadir, Bedük, Yaşar, Baltacı, Sümer, Göğüş, Çağatay, Göğüş, Orhan
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier B.V 01.12.2003; Elsevier
• Subjects: Aged; Antineoplastic Combined Chemotherapy Protocols - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Biological and medical sciences; Bladder tumor; Carcinoma, Transitional Cell - drug therapy; Carcinoma, Transitional Cell - mortality; Carcinoma, Transitional Cell - pathology; Chemotherapy; Cisplatin - administration & dosage; Cisplatin - adverse effects; Deoxycytidine - administration & dosage; Deoxycytidine - adverse effects; Deoxycytidine - analogs & derivatives; Dose-Response Relationship, Drug; Drug Administration Schedule; Female; Follow-Up Studies; Gemcitabine; Humans; Infusions, Intravenous; Male; Maximum Tolerated Dose; Medical sciences; Middle Aged; Neoadjuvant Therapy; Neoplasm Staging; Nephrology. Urinary tract diseases; Prospective Studies; Risk Assessment; Survival Analysis; Terminally Ill; Treatment Failure; Tumors of the urinary system; Urinary Bladder Neoplasms - drug therapy; Urinary Bladder Neoplasms - mortality; Urinary Bladder Neoplasms - pathology; Urinary tract. Prostate gland; Vinblastine - administration & dosage; Vinblastine - adverse effects; Vinblastine - analogs & derivatives; Vinorelbine; Chemotherapy; Gemcitabine; Bladder tumor; Vinorelbine; Antineoplastic agent; Human; Urinary system disease; Carcinoma; Treatment efficiency; Urinary tract disease; Transitional cell carcinoma; Malignant tumor; Alkaloid; Urinary bladder; Advanced stage; Bladder disease; Fluorine Organic compounds; Therapeutic protocol; Pyrimidine nucleoside; Survival curve
• ISSN: 0302-2838; 1873-7560
• DOI: 10.1016/S0302-2838(03)00385-3

Objective: To evaluate the efficacy and toxicity of gemcitabine plus vinorelbine chemotherapy in patients with advanced bladder carcinoma who are unsuitable for or who have failed cisplatin-containing chemotherapy. Patients and Methods: Thirty-one patients with advanced transitional cell carcinoma (TCC) of the bladder were scheduled to receive gemcitabine and vinorelbine chemotherapy. Twenty-one patients had received no prior chemotherapy and their creatinine clearance was below 50 ml/min (group 1), and the remaining 10 patients did not respond to previous cisplatin-containing chemotherapy (group 2). Results: In group 1, objective response rate was 47.6%, including 2 (9.5%) complete and 8 (38.9%) partial responses. In group 2, partial response was observed in 2 (20%) patients. The median survival time for patients in group 1 and 2 were 15 months (range 3–23) and 7 months (range 3–21), respectively. Grades 3 or 4 leukopenia developed in 16.1% of patients. Overall, 12.9% of the patients suffered from grade 3 nonhematologic toxicity. Conclusion: Our preliminary data indicate that the combination of gemcitabine and vinorelbine is active and well tolerated especially in patients with advanced TCC who are unsuitable for cisplatin-based chemotherapy.