[Experience with gemcitabine monotherapy in three patients with metastatic urothelial carcinoma]

Three patients who had metastatic urothelial carcinoma have been administered gemcitabine monotherapy (GEM). A 78-year-old male who underwent nephroureterectomy for right ureteral cancer presented with liver and retroperitoneal lymph node metastases postoperatively. GEM was administered because of severe renal insufficiency. Although 8 cycles of this therapy were done, we discontinued it because of progressive disease. A 68-year-old male who underwent nephroureterectomy for left ureteral cancer presented with retroperitoneal lymph node metastasis postoperatively. GEM for the purpose of maintenance therapy was administered after first-line chemotherapy. He maintained a stable disease after 9 cycles. A 70-year-old female who underwent transurethral resection of a bladder tumor presented with neck lymph node metastasis postoperatively. She was administered GEM for second-line chemotherapy as an outpatient because she did not want hospital treatment. However, it failed due to progressive disease after 3 cycles. There were few adverse events that forced the patient to be admitted into the hospital, although bone marrow suppression of grade 3 or 4 occurred in 2 patients. GEM for metastatic urothelial carcinoma may be adapted for patients who have severe renal insufficiency and need maintenance therapy.