Gemcitabine/paclitaxel-based three-drug regimens in advanced urothelial cancer (original) (raw)

Transitional cell carcinoma (TCC) of the urothelium is a highly chemosensitive tumour. Combination chemotherapy can provide both palliation and a modest survival advantage in patients with advanced disease. At present, the combination of cisplatin, methotrexate, doxorubicin and vinblastine (M-VAC) is the most widely used for advanced TCC with an overall response rate of 40± 72% in phase II, and 35±45% in phase III studies, and a median survival of approximately 12 months. These modest results and the unsuccessful attempts to increase ecacy with dose intensive M-VAC schedules have prompted the identi®cation of new active agents in TCC, such as the taxanes and gemcitabine. The overall response rates for two-drug regimens of cisplatin±paclitaxel, car-boplatin±paclitaxel and cisplatin±gemcitabine range from 63 to 72%, 14 to 65% and 42 to 66%, respectively. The overall response rates for platinum±paclitaxel±gemcitabine three-drug regimens range from 58 to 80%. The potential clinical bene®t of these new three-drug combinations in the treatment of TCC needs to be tested in future phase III studies. # -drug regimen chemotherapy; Three-drug regimen chemotherapy 0959-8049/00/$ -see front matter # 2000 Elsevier Science Ltd. All rights reserved. P I I : S 0 9 5 9 -8 0 4 9 ( 0 0 ) 0 0 0 8 1 -2