Background: We evaluated the effectiveness of gemcitabine and paclitaxel
therapy in patients with metastatic urothelial carcinoma for whom two lines of sequential
chemotherapy had been unsuccessful.Methods: A total number of 105 patients who had previously received
first-line chemotherapy consisting of gemcitabine and cisplatin or carboplatin, were
treated with second-line gemcitabine and docetaxel therapy between June 2006 and May 2015.
Of these patients, 15 with an Eastern Cooperative Oncology Group Performance Status of 0
or 1 were administered gemcitabine and paclitaxel as third-line treatment from 2013 after
failure of the second-line therapy. For each 21-day cycle, gemcitabine (1000
mg/m2) was administered on days 1, 8, and 15, and paclitaxel (200
mg/m2) on day 1. Patients were assessed for each cycle and any adverse events
were noted. Furthermore, a Short Form Health Survey questionnaire was used to assess each
patient’s quality of life.Results: Third-line gemcitabine and paclitaxel treatment cycles were
undertaken for a median of four times (range 2–9). The disease control rate was 80.0%.
After second-line gemcitabine and docetaxel therapy was completed, median progression-free
survival and median overall survival were determined as 9.8 and 13.0 months, respectively.
The only prognostic factor for overall survival, as determined by univariate and
multivariate analyses, was third-line gemcitabine and paclitaxel therapy. Neutropenia
(66.7%) and thrombocytopenia (53.3%) were noted as the grade 3 treatment-related
toxicities. After two cycles of third-line gemcitabine and paclitaxel therapy, the pre-
and post-treatment quality of life scores did not differ significantly.Conclusions: Results demonstrate that third-line combination therapy using
gemcitabine and paclitaxel is a feasible option for metastatic urothelial carcinoma
patients.