Results of a study into combination therapy with gemcitabine and epirubicin appears to be a safe and effective treatment for advanced urothelial cancers in patients who are not eligible for cisplatin-based regimens.
Cisplatin-based regimens have proven to be the most effective treatment for advanced urothelial cancers, however have been associated with severe side-effects and are often contraindicated in patients of suboptimal clinical status.
Italian researchers, headed by Dr Sergio Ricci from the S. Chiara University Hospital in Pisa, Italy studied the outcomes of 38 patients with advanced urothelial cancers who were treated with gemcitabine and epirubicin. These patients were not eligible for cisplatin-based regimens due to impaired renal function, poor performance status or advanced age.
Researchers administered a total of 152 treatment cycles and the median number of cycles per patient was four. The percentage of cycles that were associated with grade 3-4 neutropenia 22.4%; anemia 11.2%; and thrombocytopenia 6.5%. Cardiac, renal and hepatic toxicities were not observed during any of the cycles.
Overall treatment response rate was 39.5%. Two patients experienced a complete response and 13 had a partial response. Of the remaining patients, 11 had a stable disease and 12 had progressive disease.
The median overall and progression-free survival rates were eight and 4.8 months respectively. Of the 30 patients who had symptomatic disease, 17 achieved a complete symptomatic response, five had a partial response and eight had stable disease.
Researchers state, these results have ‘demonstrated that the combination of gemcitabine and epirubicin is an effective regimen that can be administered safely to patients with urothelial carcinoma with advanced age, poor performance score, and/or impaired renal function’.
‘On the basis of activity and tolerability, this regimen deserves further development, including the addition of other active agents for patients who are in good condition’, they conclude.
(Source: ASCO & Reuters Health)