TY - JOUR
TI - Efficacy of methotrexate/vinblastine/doxorubicin/cisplatin combination in gemcitabine-pretreated patients with advanced urothelial cancer: A retrospective analysis
AU - Karadimou, A.
AU - Lianos, E.
AU - Pectasides, D.
AU - Dimopoulos, M.A.
AU - Bamias, A.
JO - Open access journal of urology
PY - 2010
VL - 2
TODO - 1
SP - 193-199
PB - 
SN - null
TODO - 10.2147/OAJU.S13122
TODO - carboplatin;  cisplatin;  doxorubicin;  gemcitabine;  methotrexate;  platinum;  vinblastine, adult;  advanced cancer;  aged;  alopecia;  anemia;  article;  cancer combination chemotherapy;  cancer relapse;  cancer staging;  clinical article;  controlled study;  drug efficacy;  drug megadose;  drug response;  drug treatment failure;  female;  follow up;  histology;  human;  human tissue;  kidney disease;  male;  multiple cycle treatment;  nausea and vomiting;  neurotoxicity;  neutropenia;  overall survival;  prediction;  progression free survival;  recurrent cancer;  retrospective study;  stomatitis;  thrombocytopenia;  urogenital tract cancer;  visceral metastasis
TODO - Objective: Second-line treatment options in advanced urothelial cancer are limited. We investigated the efficacy of a methotrexate/vinblastine/doxorubicin/cisplatin (MVAC) combination after failure of gemcitabine/platinum chemotherapy. Patients and methods: Twenty-five patients with advanced urothelial cancer, who received second-line MVAC after first-line gemcitabine/cisplatin (n = 9) or gemcitabine/carboplatin (n = 16), were included in this retrospective analysis. Results: Twenty-two patients (88%) relapsed within 6 months after first-line treatment. Following MVAC, there were 5 (20%) objective responses. Median follow-up was 20.2 months. Median progression-free survival (PFS) was 3.8 months (95% CI: 2.3-5.2), and median overall survival (OS) was 9 months (95% CI: 6.6-11.4). Eastern Cooperative Oncology Group performance status 0.1 versus 2 was associated with longer PFS (5 months versus 3.3 months, P = 0.049). Response or stabilization of disease during second-line chemotherapy predicted for a significantly longer PFS and OS (7.4 versus 3.5, P = 0.005; 15.5 versus 7, P = 0.046). Conclusions: Second-line MVAC chemotherapy may result in prolonged survival in some patients with refractory disease. Further research in this field is necessary. © 2010 Karadimou et al, publisher and licensee Dove Medical Press Ltd.
ER -