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FOLFOX-4 in pre-treated patients with advanced transitional cell carcinoma of the bladder
Giuseppe Di Lorenzo1, Riccardo Autorino, Antonio Giordano
1Dipartimento di Endocrinologia e Oncologia Molecolare e Clinica, Seconda Università degli Studi, Naples, Italy. giuseppedilorenzoncol@hotmail.com
Background:
Despite recent progress in the treatment of advanced urothelial cancer, there continues to be a need to identify new active agents and their toxicity spectra. We conducted a study using FOLFOX-4 (oxaliplatin, fluorouracil, folinic acid) in pre-treated advanced bladder cancer patients.
Methods:
Sixteen eligible patients with advanced disease were treated with oxaliplatin (85 mg/m(3)) on day 1 followed by fluorouracil and folinic acid (De Gramont schedule) on days 1 and 2 every 14 days until disease progression. All patients received nutritional support to increase their caloric intake. Objective responses and toxicity were evaluated. Biochemical responses (reduction of markers) and nutritional parameters (increase in body weight and albumin, and reduction in ferritin and C-reactive protein) were also considered.
Results:
Three patients obtained an objective response (overall response rate 19%). Hematological toxicity and stomatitis were the most commonly noted side effects, but we observed only low (3-4) grade toxicity. In four patients (25%), we observed a reduction in tumoral markers (carcinoembryonic antigen and tissutal polypeptide antigen) and modified nutritional parameters.
Conclusions:
Using these doses and schedules of FOLFOX-4 appears to be a promising therapy in patients pre-treated with platinum compounds. More studies are required to assess the possible role of this regimen in the treatment of advanced bladder cancer.
Insights
FOLFOX-4 chemotherapy shows promise for pre-treated advanced bladder cancer patients, with a 19% response rate and manageable toxicity. Further research is needed to confirm its role in urothelial cancer treatment.
Area of Science:
- Oncology
- Medical Chemistry
Background:
- Advanced urothelial cancer treatment requires novel agents and toxicity profiling.
- Previous treatments for advanced bladder cancer have limitations.
Purpose of the Study:
- To evaluate the efficacy and toxicity of FOLFOX-4 in pre-treated advanced bladder cancer patients.
- To assess biochemical and nutritional responses to the treatment regimen.
Main Methods:
- A study involving sixteen eligible patients with advanced bladder cancer.
- Treatment administered: oxaliplatin, fluorouracil, and folinic acid (FOLFOX-4) every 14 days.
- Evaluation of objective responses, toxicity, biochemical markers, and nutritional parameters.
Main Results:
- An overall response rate of 19% (3 patients) was observed.
- Common toxicities included hematological issues and stomatitis, with low grade (3-4).
- Tumoral markers and nutritional parameters improved in 25% of patients.
Conclusions:
- FOLFOX-4 demonstrates potential as a promising therapy for platinum-pre-treated advanced bladder cancer.
- Additional studies are necessary to fully establish the role of FOLFOX-4 in urothelial cancer treatment.
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