Carboplatin-gemcitabine treatment of patients with transitional cell carcinoma of the bladder and impaired renal function

Introduction: Bladder cancer is a frequently occurring tumour in Spain and usually affects elderly patients with renal impairment. The development of new combination therapies for such patients is thus of vital importance. Pa tients and Methods: Between 1997 and 1998, 17 patients with locally advance d non-surgical or metastatic bladder tumours were treated at our centres. T reatment consisted of 1,000 mg/m(2) of gemcitabine administered on days 1 a nd 8, and carboplatin (area under the concentration curve = 5) on day 1, ev ery 21 days. Results: The mean age of the patients [4 females (26%) and 13 males] was 69 years (range: 54-78 years). The average Karnofsky performance status was 80% (range: 50-100%). Mean creatinine clearance was 45.4 ml/min (range: 21-55 ml/min). There were 2 complete responses, 7 partial response s (RO: 56%; range 31-81%), 6 patients had stable disease and 1 disease prog ression. Haematological toxicities were as follows: grade I anaemia in 2 pa tients, grade III in 3; grade I granulocytopenia in 2 patients, grade III-I V in 4 patients; grade III thrombocytopenia in 3 patients. Toxic death occu rred in the course of one grade IV neutropenic event. Non-haematological to xicities were as follows: grade I-II vomiting in 3 patients and grade III i n 1. One patient had grade III hepatic toxicity. One patient had grade III renal toxicity, and 3 patients grade II alopecia. Conclusions: The above-me ntioned treatment has low toxicity, is easy to administer and offers promis ing results in this group of patients. Copyright (C) 2000 S. Karger AG, Bas el.