Researchers who conducted a large, randomized clinical trial across Europe, Great Britain, and Canada found that in order to improve safety and reduce toxicity, advanced bladder cancer patients can be treated with a combination of gemcitabine(Drug information on gemcitabine) (Gemzar) and cisplatin(Drug information on cisplatin) (Platinol). This combination (known as GC) did not extend survival, but it was much less toxic than the currently used combination, MVAC (methotrexate, vinblastine, doxorubicin(Drug information on doxorubicin) [Adriamycin], and cisplatin).
Safer Alternative
Compared to 196 patients who were treated with MVAC, the 200 patients who received GC had a lower incidence of adverse events, including low white blood cell count (82% vs 71%, respectively), fever (14% vs 2%), severe infection (12% vs 1%), and mouth sores (22% vs 1%). There were also fewer chemotherapy-related deaths in patients receiving GC (1%) compared to those receiving MVAC (3%). In general, patients treated with GC had less weight loss and fatigue and better overall physical functioning compared to patients treated with MVAC.
“GC is a safer therapeutic alternative for patients with locally advanced and metastatic bladder cancer,” said oncologist Professor Hans von der Masse, of Aarhus University Hospital in Aarhus, Denmark. He added that GC should also be tested in patients with early-stage bladder cancer.
A 70-year-old man with a history of localized prostate cancer treated with whole-pelvis radiation therapy with a boost to the prostate, in conjunction with androgen deprivation therapy 7 years prior, presented with lower back pain. A bone scan revealed an area of activity in the sacrum. What is the most likely diagnosis?
