Systemic chemotherapy in patients with advanced transitional cell carcinoma of the urothelium and impaired renal function

作者：El Demery Mounira; Thezenas Simon; Pouessel Damien; Culine Stephane^*

来源：Anti-Cancer Drugs, 2012, 23(2): 143-148.

DOI：10.1097/CAD.0b013e32834c2ab6

• chemotherapy
• cisplatin
• impaired renal function
• urothelial carcinoma

Cisplatin is the backbone of chemotherapeutic regimens used in the treatment of advanced transitional cell carcinoma of the urothelium. However, about 50% of patients cannot be administered cisplatin because of impaired renal functions. A review of the different approaches that have been developed in this patient population was performed through a Medline search from 1 January 1998 to 31 December 2010. Twenty-six studies including 25 phase II and one randomized phase II/III studies were analyzed. All regimens, except one, were based on gemcitabine and/or carboplatin and/or paclitaxel. Only five (20%) out of 25 phase II studies actually include homogeneous patients with an impaired renal function defined by a creatinine clearance below 60 ml/min. One hundred and eight patients with a median creatinine clearance ranging from 28 to 48 ml/min received four different chemotherapy regimens including one to four drugs. The results showed the response rates to vary from 24 to 56% and survival to range from 7 to 15 months. No standard chemotherapy can be recommended from literature data. Future randomized studies will have to solve the following questions: what is the optimal definition of cisplatin eligibilit

• 出版日期2012-2