A two-drug combination regimen may provide a more tolerable therapy for patients suffering from advanced bladder cancer, many of whom are elderly.
According to a study published in the January issue of the Journal of Clinical Oncology, clinicians at the University of Pennsylvania Cancer Center have demonstrated that the combination of paclitaxel (Taxol) and carboplatin (Paraplatin) is tolerable and has significant antitumor effects.
The researchers treated 33 patients with advanced bladder cancer (mean age, 70 years) with paclitaxel intravenously over 3 hours followed by carboplatin for 30 minutes. Patients who participated in the trial were treated at the Hospital of the University of Pennsylvania (HUP) and other local Philadelphia hospitals, and toxicity levels were monitored frequently.
Standard Regimen Often Too Harsh for Elderly
David Vaughn, md, assistant professor of medicine and principal investigator of the study, noted that the standard regimen for advanced bladder cancer is often too harsh for elderly patients and may cause significant side effects.
Commonly, treatment of advanced bladder cancer involves the administration of the MVAC (methotrexate, vinblastine, Adriamycin, and cisplatin) regimen. This four-drug regimen can result in severe side effects and is not well tolerated by elderly patients, especially those in frail health. In addition, MVAC is difficult to administer to patients with renal impairment, which may be seen in this population.
We observed that many of the patients tumors actually shrunk [with paclitaxel-carboplatin], said Vaughn. And we believe that their quality of life greatly improved. The regimen was tolerable in most patients who normally might not be physically able to undergo the standard treatment and the patients faired well with the two-drug combination therapy, he concluded.