Long-term survival results of a randomized trial comparing gemcitabine/cisplatin and methotrexate/vinblastine/doxorubicin/cisplatin in patients with locally advanced and metastatic bladder cancer

Roberts, J.T.; Maase, Hans von der; Sengeløv, Lisa; Conte, Pierfranco; Dogliotti, Luigi; Oliver, T.; Moore, Malcolm J.; Zimmermann, Anna; Arning, M.

doi:10.1093/annonc/mdj965

Cited by 102 publications

(73 citation statements)

References 14 publications

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“…These results were comparable with the results from studies using the same gemcitabine-cisplatin combination against advanced transitional cell carcinoma 8,15,16 . However, the overall response rate (47.6%) and CR (14.3) in the GC therapy in this study is lower than the results reported by Khaled HM,et al 17 .…”

Section: Discussionsupporting

confidence: 82%

Gemcitabine and Cisplatin Versus Methotrexate, Vinblastine, Doxorubicin, and Cisplatin In Advanced and or Metastatic Bilharzial Urothelial Carcinoma of the Bladder in Egypt.

Mohamed

Al-Gezawy

Mostafa

2011

Kasr-Al-Aini J.of Clin. Onc. and Nuc. Med.

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Purpose: Gemcitabine plus cisplatin (GC) and methotrexate, vinblastine, doxorubicin, and cisplatin (MVAC) were compared in patients with locally advanced or metastatic bilharzial urothelial carcinoma. Patients and Methods: Patients with with locally advanced or metastatic bilharzial urothelial carcinoma (no prior systemic chemotherapy) were randomized to GC (gemcitabine 1,000 mg/m 2 days 1, 8, 15, cisplatin 70 mg/m 2 day 2) or standard MVAC every 28 days for a maximum of six cycles (Methotrexate = 30 mg/m 2 on days 1, 15 and 22, Vinblastine = 3 mg/m 2 on days 2, 15 and 22,Doxorubicin = 30 mg/m 2 on day 2 and Cisplatin = 70 mg/m 2 on day 2 (1-2 h infusion). Results: forty-one patients were randomized, twenty-one to the GC arm and twenty to the MVAC arm. Overall survival was similar(13 months) on both arms. Time to progressive disease was 7 months with GC group and 6 months with MVAC group and response rate (GC, 47.6% vs MVAC 45%). Significant prognostic factors correlating with better overall survival were Karnofsky performance status ≥ 70, TNM staging (Mo vs.M1) and the absence of visceral metastasis. Hematologic toxicities were significantly higher with GC therapy. More GC patients, compared with MVAC patients had grade 3/4 anemia (28.5% vs 15%) and thrombocytopenia (47.6% vs 25%). More MVAC patients, compared with GC patients had grade 3/4 neutropenia (80% vs 67.6% P = 0.001), grade 3/4 mucositis (20% v 9.5%) and alopecia (25% v 14.3%) Conclusion: GC provides a similar survival advantage to MVAC with a better tolerability. These results strengthen the role of GC as a standard of care in patients with locally advanced or metastatic bilharzial-related urothelial carcinoma.

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Section: Discussionsupporting

confidence: 82%

Gemcitabine and Cisplatin Versus Methotrexate, Vinblastine, Doxorubicin, and Cisplatin In Advanced and or Metastatic Bilharzial Urothelial Carcinoma of the Bladder in Egypt.

Mohamed

Al-Gezawy

Mostafa

2011

Kasr-Al-Aini J.of Clin. Onc. and Nuc. Med.

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“…200 The 5-year survival rates between GC and MVAC were also similar. 201 A phase 3 trial of high-dose-intensity MVAC with recombinant human granulocyte colony-stimulating factor (G-CSF) versus MVAC alone demonstrated that high-dose-intensity MVAC enabled delivery of higher doses of chemotherapy in a shorter time, but there was no difference in survival between the 2 groups. 202 Paclitaxel is a drug that stabilizes microtubules and promotes their assembly, which results in an Mphase cell-cycle arrest.…”

Section: Urinary Diversionmentioning

confidence: 99%

Bladder Cancer in 2010: How Far have We Come?

Jacobs¹,

Lee

Montie

2010

CA: A Cancer Journal for Clinicians

300

275

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Bladder cancer is the fourth most common cancer and ranks eighth as a cause of death from cancer among men in the United States. Although guidelines assist in treatment, the art of managing bladder cancer, such as the decision to use neoadjuvant chemotherapy and the timing of cystectomy, is still variable. Bladder cancer has a propensity to recur, and with recurrence, a significant number of cases progress, which makes the early detection of high-risk patients imperative. Advances in detection, surveillance, and treatment of bladder cancer are reviewed in this article.

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“…5 Consequently, costs for chemotherapy were extrapolated from a multinational costing study that assessed the costs of gemcitabine/cisplatin in nonsmall cell lung cancer. 26 Because the administration, dosage, and number of cycles of chemotherapy is similar for the treatment of advanced lung cancer and bladder cancer, [27][28][29] we assumed that the chemotherapyrelated complications and medical oncology workload between the 2 disease sites would be similar. The cost of dying from cancer or from other causes was extrapolated from an ongoing comprehensive casecosting study for prostate cancer (unpublished data).…”

Section: Costsmentioning

confidence: 99%

Cost‐effectiveness analysis of immediate radical cystectomy versus intravesical Bacillus Calmette‐Guerin therapy for high‐risk, high‐grade (T1G3) bladder cancer

Kulkarni

Alibhai

Finelli

et al. 2009

Cancer

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Partially fluorinated poly(vinyl ether)s with C4F9 and C6F12H groups in the side chain were synthesized via living cationic polymerization in the presence of an added base in a fluorine‐containing solvent, dichloropentafluoropropanes. For comparison, the polymerization of vinyl ether monomers with C2F5 and C6F13 groups and nonfluorinated monomers were also carried out. The characterization of the product polymers using size exclusion chromatography with a fluorinated solvent as an eluent indicated that all polymers had narrow molecular weight distributions (Mw/Mn ∼ 1.1). Interestingly, the moderately fluorinated polymers with C4F9 exhibited upper critical solution temperature‐type phase separation in various organic solvents with wide‐ranging polarities, whereas highly fluorinated polymers with C6F13 are insoluble in nonfluorinated solvents. Polymers with C4F9 groups exhibited temperature dependent solubility transitions not only in common organic solvents (e.g., toluene, chloroform, tetrahydrofuran, and acetone) but also in perfluoro solvents [e.g., perfluoro(methylcyclohexane) and perfluorodecalin]. On the other hand, the solubility of polymers with C6F12H showed completely different from that of polymers with C6F13, despite their similar fluorine content. In addition, various types of fluorinated block copolymers were prepared in a living manner. The block copolymers with a thermosensitive fluorinated segment underwent temperature‐induced micellization and sol–gel transition in various organic solvents. © 2011 Wiley Periodicals, Inc. J Polym Sci Part A: Polym Chem, 2011

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Long-term survival results of a randomized trial comparing gemcitabine/cisplatin and methotrexate/vinblastine/doxorubicin/cisplatin in patients with locally advanced and metastatic bladder cancer

Abstract: Long-term overall and progression-free survival following treatment with GC or MVAC are similar. These results strengthen the role of GC as a standard of care in patients with locally advanced and metastatic transitional-cell carcinoma (TCC).

Cited by 102 publications

References 14 publications

Gemcitabine and Cisplatin Versus Methotrexate, Vinblastine, Doxorubicin, and Cisplatin In Advanced and or Metastatic Bilharzial Urothelial Carcinoma of the Bladder in Egypt.

Gemcitabine and Cisplatin Versus Methotrexate, Vinblastine, Doxorubicin, and Cisplatin In Advanced and or Metastatic Bilharzial Urothelial Carcinoma of the Bladder in Egypt.

Bladder Cancer in 2010: How Far have We Come?

Cost‐effectiveness analysis of immediate radical cystectomy versus intravesical Bacillus Calmette‐Guerin therapy for high‐risk, high‐grade (T1G3) bladder cancer

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