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Shigenori Kakutani, Hiroshi Fukuhara, Satoru Taguchi, Masayoshi Nagata, Aya Niimi, Mami Hattori, Hideyo Miyazaki, Tetsuya Fujimura, Tohru Nakagawa, Haruki Kume, Yasuhiko Igawa, Yukio Homma, Combination of docetaxel, ifosfamide and cisplatin (DIP) as a potential salvage chemotherapy for metastatic urothelial carcinoma, Japanese Journal of Clinical Oncology, Volume 45, Issue 3, March 2015, Pages 281–285, https://doi.org/10.1093/jjco/hyu201
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Abstract
The aim of this study was to evaluate the efficacy and toxicity of the combination of docetaxel, ifosfamide and cisplatin as salvage chemotherapy after failure of standard cisplatin-based regimens for metastatic urothelial carcinoma.
We prospectively administered docetaxel, ifosfamide and cisplatin chemotherapy to patients with metastatic urothelial carcinoma refractory to standard cisplatin-based regimens from 2003 to 2013. Patients who had received only adjuvant and/or neoadjuvant chemotherapy were excluded. Eligible patients received every 28 days docetaxel 60 mg/m2 on Day 1, ifosfamide 1.0 g/m2 on Days 2–6 and cisplatin 20 mg/m2 on Days 2–6. The primary endpoints were progression-free survival and overall survival, calculated from the start of docetaxel, ifosfamide and cisplatin chemotherapy. Secondary endpoints included objective response and related toxicity.
Twenty-six cases received a median of 3.0 cycles of docetaxel, ifosfamide and cisplatin chemotherapy (interquartile range: 2–5), resulting in a median progression-free survival of 3 months (interquartile range: 2–9.5 months) and median overall survival of 8.5 months (interquartile range: 6.5–18.75 months), respectively. Of 26 patients, seven (27%) achieved major treatment responses, with one complete response (4%) and six partial responses (23%). Most of Grade 3/4 toxicities were hematologic events, including leukopenia (77%), anemia (54%) and thrombocytopenia (46%). No death from toxicity was observed.
Our results indicate that docetaxel, ifosfamide and cisplatin chemotherapy is a tolerable and moderately active regimen for metastatic urothelial carcinoma after failure of standard cisplatin-based regimens.
