The combination of gemcitabine and paclitaxel is active and well tolerated as a second-line treatment in patients with advanced urothelial carcinoma.

There have been several studies on the antitumor activities of vitamin E succinate (a-TOS) as complementary and alternative medicine. In the present study, we investigated the cytotoxic effect of a-TOS and the enhancement of chemosensitivity to paclitaxel by a-TOS in bladder cancer. and 5637 bladder cancer cell lines were cultured in a-TOS and ⁄ or paclitaxel in vitro. Cell viability, flow cytometric analysis, and nuclear factor-kappa B (NF-jB) activity were analyzed. For in vivo therapeutic experiments, preestablished KU-19-19 tumors were treated with a-TOS and ⁄ or paclitaxel. In KU-19-19 and 5637 cells, the combination treatment resulted in a significantly higher level of growth inhibition, and apoptosis was significantly induced by the combination treatment. NF-jB was activated by paclitaxel; however, the activation of NFjB was inhibited by a-TOS. Also, the combination treatment significantly inhibited tumor growth in mice. In the immunostaining of the tumors, apoptosis was induced and proliferation was inhibited by the combination treatment. Combination treatment of a-TOS and paclitaxel showed promising anticancer effects in terms of inhibiting bladder cancer cell growth and viability in vitro and in vivo. One of the potential mechanisms by which the combination therapy has synergistic cytotoxic effects against bladder cancer may be that a-TOS inhibits NF-jB induced by chemotherapeutic agents. (Cancer Sci 2010; 101: 216-223) T he prognosis for patients with advanced or metastatic bladder cancer remains poor, with a median survival of approximately 12 months. Systemic chemotherapy is the only current modality that provides the potential for somewhat long-term survival in patients with advanced or metastatic bladder cancer. Methotrexate, vinblastine, doxorubicin, and cisplatin (M-VAC) has been the most common treatment regimen for advanced or metastatic bladder cancer since the 1980s.(1) The M-VAC regimen has been reported to produce a complete response in approximately 20% of patients, although long-term disease-free survival is rare.(2) M-VAC, though superior to single agent therapy, is associated with significant toxicity (more than 20% of recipients experience neutropenic fever). These disappointing results have prompted a search for additional agents and multidrug combinations.Taxoids are microtubule disassembly inhibitors and represent a new class of agents for use in cancer chemotherapy. Recently, the use of paclitaxel or docetaxel, a semisynthetic taxane, has been started in clinical trials in patients with advanced bladder cancer. Paclitaxel has demonstrated substantial single-agent activity in the treatment of advanced or metastatic bladder cancer. (3,4) Paclitaxel in combination with gemcitabine has shown promise for the treatment of patients with M-VAC refractory bladder cancer.(5,6) Paclitaxel causes cell death by inhibiting depolymerization of tubulin with resultant arrest in cell cycle progression, particularly at the G2 ⁄ M interface.(7) Besides this function, it also possesses cell-killin...

No abstract

PSA bounce is not a rare phenomenon after prostate brachytherapy. It is more common in younger patients and patients receiving higher doses of radiation.

No abstract