Significant activity of paclitaxel in advanced transitional-cell carcinoma of the urothelium

A phase II trial of the Eastern Cooperative Oncology Group

Bruce J. Roth, Robert Dreicer, Lawrence Einhorn, Donna Neuberg, David H. Johnson, Julia L. Smith, Gary R. Hudes, Stephen M. Schultz, Patrick Loehrer

Research output: Contribution to journalArticle

295 Citations (Scopus)

Abstract

Purpose: To assess the efficacy and toxicity of single-agent paclitaxel as first-line chemotherapy in patients with locally advanced or metastatic transitional-cell carcinoma of the urothelium. Patients and Methods: Twenty- six eligible patients were enrolled onto this cooperative group study and treated with paclitaxel at a dosage of 250 mg/m2 by 24-hour continuous infusion every 21 days until progression or patient intolerance. All patients received recombinant human granulocyte colony-stimulating factor (rhG-CSF) at 5 μg/kg/d for at least 10 days during each cycle. Results: Eleven of 26 patients (42%; 95% confidence interval [CI], 23% to 63%) demonstrated an objective response, with seven achieving a complete clinical response (CR) (27%; 95% CI, 12% to 48%) and four (15%) a partial response (PR). The median duration of response in the 11 responders is 7+ months (range, 4 to 17), with five responders (four CRs, one PR) remaining progression-free at 5, 6, 10, 12, and 16 months from the start of therapy. The estimated median survival duration for all patients is 8.4 months. Hematologic toxicity consisted of anemia (12% grade 3) and granulocytopenia (4% grade 3, 19% grade 4), with two patients developing granulocytopenic fevers. Nonhematologic toxicity included grade 3 mucositis in 11%, grade 3 neuropathy in 11%, and grade 4 diarrhea in 4%. Conclusion: Single-agent paclitaxel at this dosage and schedule is one of the most active single agents in previously untreated patients with advanced urothelial carcinoma, and is well tolerated by this patient population when given with hematopoietic growth factor support.

Original languageEnglish (US)
Pages (from-to)2264-2270
Number of pages7
JournalJournal of Clinical Oncology
Volume12
Issue number11
StatePublished - Nov 1994
Externally publishedYes

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Urothelium
Transitional Cell Carcinoma
Paclitaxel
Confidence Intervals
Mucositis
Agranulocytosis
Granulocyte Colony-Stimulating Factor
Anemia
Diarrhea
Intercellular Signaling Peptides and Proteins
Appointments and Schedules
Fever
Carcinoma
Drug Therapy

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Significant activity of paclitaxel in advanced transitional-cell carcinoma of the urothelium : A phase II trial of the Eastern Cooperative Oncology Group. / Roth, Bruce J.; Dreicer, Robert; Einhorn, Lawrence; Neuberg, Donna; Johnson, David H.; Smith, Julia L.; Hudes, Gary R.; Schultz, Stephen M.; Loehrer, Patrick.

In: Journal of Clinical Oncology, Vol. 12, No. 11, 11.1994, p. 2264-2270.

Research output: Contribution to journalArticle

Roth, Bruce J. ; Dreicer, Robert ; Einhorn, Lawrence ; Neuberg, Donna ; Johnson, David H. ; Smith, Julia L. ; Hudes, Gary R. ; Schultz, Stephen M. ; Loehrer, Patrick. / Significant activity of paclitaxel in advanced transitional-cell carcinoma of the urothelium : A phase II trial of the Eastern Cooperative Oncology Group. In: Journal of Clinical Oncology. 1994 ; Vol. 12, No. 11. pp. 2264-2270.
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abstract = "Purpose: To assess the efficacy and toxicity of single-agent paclitaxel as first-line chemotherapy in patients with locally advanced or metastatic transitional-cell carcinoma of the urothelium. Patients and Methods: Twenty- six eligible patients were enrolled onto this cooperative group study and treated with paclitaxel at a dosage of 250 mg/m2 by 24-hour continuous infusion every 21 days until progression or patient intolerance. All patients received recombinant human granulocyte colony-stimulating factor (rhG-CSF) at 5 μg/kg/d for at least 10 days during each cycle. Results: Eleven of 26 patients (42{\%}; 95{\%} confidence interval [CI], 23{\%} to 63{\%}) demonstrated an objective response, with seven achieving a complete clinical response (CR) (27{\%}; 95{\%} CI, 12{\%} to 48{\%}) and four (15{\%}) a partial response (PR). The median duration of response in the 11 responders is 7+ months (range, 4 to 17), with five responders (four CRs, one PR) remaining progression-free at 5, 6, 10, 12, and 16 months from the start of therapy. The estimated median survival duration for all patients is 8.4 months. Hematologic toxicity consisted of anemia (12{\%} grade 3) and granulocytopenia (4{\%} grade 3, 19{\%} grade 4), with two patients developing granulocytopenic fevers. Nonhematologic toxicity included grade 3 mucositis in 11{\%}, grade 3 neuropathy in 11{\%}, and grade 4 diarrhea in 4{\%}. Conclusion: Single-agent paclitaxel at this dosage and schedule is one of the most active single agents in previously untreated patients with advanced urothelial carcinoma, and is well tolerated by this patient population when given with hematopoietic growth factor support.",
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N2 - Purpose: To assess the efficacy and toxicity of single-agent paclitaxel as first-line chemotherapy in patients with locally advanced or metastatic transitional-cell carcinoma of the urothelium. Patients and Methods: Twenty- six eligible patients were enrolled onto this cooperative group study and treated with paclitaxel at a dosage of 250 mg/m2 by 24-hour continuous infusion every 21 days until progression or patient intolerance. All patients received recombinant human granulocyte colony-stimulating factor (rhG-CSF) at 5 μg/kg/d for at least 10 days during each cycle. Results: Eleven of 26 patients (42%; 95% confidence interval [CI], 23% to 63%) demonstrated an objective response, with seven achieving a complete clinical response (CR) (27%; 95% CI, 12% to 48%) and four (15%) a partial response (PR). The median duration of response in the 11 responders is 7+ months (range, 4 to 17), with five responders (four CRs, one PR) remaining progression-free at 5, 6, 10, 12, and 16 months from the start of therapy. The estimated median survival duration for all patients is 8.4 months. Hematologic toxicity consisted of anemia (12% grade 3) and granulocytopenia (4% grade 3, 19% grade 4), with two patients developing granulocytopenic fevers. Nonhematologic toxicity included grade 3 mucositis in 11%, grade 3 neuropathy in 11%, and grade 4 diarrhea in 4%. Conclusion: Single-agent paclitaxel at this dosage and schedule is one of the most active single agents in previously untreated patients with advanced urothelial carcinoma, and is well tolerated by this patient population when given with hematopoietic growth factor support.

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