© 2005 Foundation for Promotion of Cancer Research
Combination Chemotherapy of Docetaxel, Ifosfamide and Cisplatin (DIP) in Patients with Metastatic Urothelial Cancer: a Preliminary Report
Department of Urology, Faculty of Medicine, Tokyo University, Tokyo, Japan
For reprints and all correspondence: Satoru Takahashi, Department of Urology, Faculty of Medicine, Tokyo University, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. E-mail: takahashi-uro{at}h.u-tokyo.ac.jp
Received September 13, 2004; accepted December 20, 2004
Objective: The aim of this study was to evaluate the efficacy and toxicity of a new combination chemotherapy of docetaxel, ifosfamide and cisplatin (DIP) in the treatment of metastatic urothelial cancer.
Methods: Fourteen patients (nine male and five female; aged 5982 years) with metastatic urothelial carcinoma, including five patients who have a history of methotrexate, vinblastine, doxorubicin and cisplatin (MVAC) chemotherapies, received the combination of docetaxel 60 mg/m2 on day 1, and ifosfamide 1.0 g/m2 and cisplatin 20 mg/m2 on days 26 and repeated every 21 days, to a maximum of six cycles. Eligibility criteria included performance status (World Health Organization) 03; normal bone marrow and liver function; and no symptomatic peripheral neuropathy.
Results: Ten of the 14 patients (72%) demonstrated a partial response (PR), with durations of response ranging from 3 to 12 months [median 6.5 months; 95% confidence interval (CI), 4.18.7 months]. The response rate of the five patients with MVAC-refractory cancer was 80% with median duration of response 5.5 months, comparable with that of the cases without previous MVAC therapies. Grade 34 granulocytopenia occurred in 10 cases (71%), resulting in three episodes (21%) of febrile neutropenia. Grade 3 thrombocytopenia was observed in five cases (36%). No toxic death was observed. Grade 2 peripheral neuropathy was identified in one case.
Conclusions: This pilot study demonstrated that DIP is an effective regimen for the treatment of metastatic urothelial cancer, and warrants further investigation.
Key Words: docetaxel ifosfamide cisplatin metastatic urothelial cancer
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