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Predicting the response of patients with advanced urothelial cancer to methotrexate, vinblastine, Adriamycin, and cisplatin (MVAC) after the failure of gemcitabine and platinum (GP)

 Ki Hong Kim  ;  Sung Joon Hong  ;  Kyung Seok Han 
 BMC CANCER, Vol.15 : 812, 2015 
Journal Title
Issue Date
Aged ; Antineoplastic Combined Chemotherapy Protocols/administration & dosage* ; Cisplatin/administration & dosage ; Deoxycytidine/administration & dosage ; Deoxycytidine/analogs & derivatives* ; Disease-Free Survival ; Doxorubicin/administration & dosage ; Female ; Follow-Up Studies ; Humans ; Male ; Methotrexate/administration & dosage ; Middle Aged ; Platinum/administration & dosage* ; Predictive Value of Tests ; Treatment Failure ; Urologic Neoplasms/diagnosis* ; Urologic Neoplasms/drug therapy* ; Urothelium/pathology* ; Vinblastine/administration & dosage
Urothelial carcinoma ; Chemotherapy ; Cisplatin ; Second-line
BACKGROUND: Platinum-based systemic chemotherapy is the treatment of choice for patients with advanced urothelial carcinoma (UC). Although no chemotherapeutic regimen is established as a second-line therapy, recent studies reported that methotrexate, vinblastine, Adriamycin and cisplatin (MVAC) elicited a significant response in patients who failed gemcitabine and platinum (GP) chemotherapy. We investigated the clinical factors useful for predicting a favourable response to MVAC in UC patients who failed GP. METHODS: Forty-five patients with advanced UC who received second-line MVAC chemotherapy after failure with first-line GP chemotherapy were enrolled in this study. Univariate and multivariate analyses based on Cox's regression were performed to identify independent prognostic factors for progression-free survival (PFS) after second-line MVAC chemotherapy. RESULTS: The median follow-up period after the first MVAC administration was 10.0 months. The median PFS and overall survival (OS) were 6.5 months (95% confidence interval [CI]: 5.1-7.9) and 14.5 months (95% CI, 7.4-21.4), respectively. The overall response rate was 57.8%. The response to first-line GP chemotherapy (hazard ratio [HR], 2.500; p = 0.012) and patient age (HR, 1.047; p = 0.033) were predictors of PFS after MVAC chemotherapy. CONCLUSIONS: The response to first-line GP chemotherapy and age were independent predictors of PFS in patients who received second-line MVAC chemotherapy. This report is the first to describe independent predictors of PFS after MVAC chemotherapy.
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1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Ki Hong(김기홍)
Han, Kyung Seok(한경석)
Hong, Sung Joon(홍성준) ORCID logo https://orcid.org/0000-0001-9869-065X
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