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Paclitaxel/Carboplatin One Chemo Option in Advanced Urothelial Carcinoma

A combination of paclitaxel plus carboplatin is one chemotherapy option for patients with advanced urothelial carcinoma and renal dysfunction.

After conducting a phase II trial with 42 patients, researchers from the United States Eastern Cooperative Oncology Group (ECOG) suggest future trials are warranted to develop chemotherapy for this patient population.

Investigators led by Dr. David Vaughan of the Abramson Cancer Centre at the University of Pennsylvania in Philadelphia, Pennsylvania, accrued 42 patients with advanced urothelial carcinoma and renal dysfunction. They treated 37 eligible patients with paclitaxel at 225 mg/m² over three hours followed by targeted carboplatin, targeted area under the concentration-time curve of 6 mg/mL/minute every three weeks for up to six cycles. Participants received a median of four cycles of chemotherapy, ranging from one to six cycles.

The researchers report the objective response rate was 24.3 percent (95 percent confidence interval, 11.9-41.7 percent). Median progression-free survival was three months and median overall survival was 7.1 months.

Risk factors for poor prognosis were ECOG performance status greater than one, or lung, liver or bone metastases. The number of poor prognostic risk factors significantly predicted survival. The most common Grade 3 toxicities were granulocytopenia, seen in 60 percent of patients, and neurotoxicity, seen in 35 percent of patients.
Cancer, 2002; 95: 1022-1027 "Phase II study of paclitaxel plus carboplatin in patients with advanced carcinoma of the urothelium and renal dysfunction (E2896) : A trial of the Eastern Cooperative Oncology Group"

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