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Japanese Journal of Clinical Oncology 2004 34(12):747-750; doi:10.1093/jjco/hyh132
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© 2004 Foundation for Promotion of Cancer Research

FOLFOX-4 in Pre-treated Patients with Advanced Transitional Cell Carcinoma of the Bladder

Giuseppe Di Lorenzo1, Riccardo Autorino2, Antonio Giordano1, Mario Giuliano1, Massimo D'Armiento2, Angelo R. Bianco1 and Sabino De Placido1

1 Cattedra di Oncologia Medica, Dipartimento di Endocrinologia e Oncologia Molecolare e Clinica and2 Clinica Urologica, Seconda Università degli Studi, Naples, Italy

For reprints and all correspondence: Giuseppe Di Lorenzo, Dipartimento di Endocrinologia e Oncologia Molecolare e Clinica, Università degli Studi di Napoli Federico II, Naples, Italy. E-mail: giuseppedilorenzoncol{at}hotmail.com

Received August 27, 2004; accepted September 23, 2004

Background: Despite recent progress in the treatment of advanced urothelial cancer, there continues to be a need to identify new active agents and their toxicity spectra. We conducted a study using FOLFOX-4 (oxaliplatin, fluorouracil, folinic acid) in pre-treated advanced bladder cancer patients.

Methods: Sixteen eligible patients with advanced disease were treated with oxaliplatin (85 mg/m3) on day 1 followed by fluorouracil and folinic acid (De Gramont schedule) on days 1 and 2 every 14 days until disease progression. All patients received nutritional support to increase their caloric intake. Objective responses and toxicity were evaluated. Biochemical responses (reduction of markers) and nutritional parameters (increase in body weight and albumin, and reduction in ferritin and C-reactive protein) were also considered.

Results: Three patients obtained an objective response (overall response rate 19%). Hematological toxicity and stomatitis were the most commonly noted side effects, but we observed only low (3–4) grade toxicity. In four patients (25%), we observed a reduction in tumoral markers (carcinoembryonic antigen and tissutal polypeptide antigen) and modified nutritional parameters.

Conclusions: Using these doses and schedules of FOLFOX-4 appears to be a promising therapy in patients pre-treated with platinum compounds. More studies are required to assess the possible role of this regimen in the treatment of advanced bladder cancer.

Key Words: chemotherapy • advanced disease • bladder cancer


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