Pathological Complete Response Induced by the Combination Therapy of Gemcitabine and 24-h Infusion of Cisplatin in Two Cases Initially Diagnosed as Node-Positive Advanced Urothelial Carcinomas

• Kenji Ina

  Department of Medical Oncology, Nagoya Memorial Hospital, Nagoya, Japan

• Ryuichi Furuta

  Department of Medical Oncology, Nagoya Memorial Hospital, Nagoya, Japan

• Tomoko Nishio

  Department of Pathology, Nagoya Memorial Hospital, Nagoya, Japan

• Satoshi Kayukawa

  Department of Clinical Oncology, Nagoya Memorial Hospital, Nagoya, Japan

• Takae Kataoka

  Department of Clinical Oncology, Nagoya Memorial Hospital, Nagoya, Japan

• Haruhito Totani

  Department of Clinical Oncology, Nagoya Memorial Hospital, Nagoya, Japan

• Takashi Kanamori

  Department of Clinical Oncology, Nagoya Memorial Hospital, Nagoya, Japan

• Takaki Kikuchi

  Department of Clinical Oncology, Nagoya Memorial Hospital, Nagoya, Japan

• Shun Umeda

  Department of Urology, Nagoya Memorial Hospital, Nagoya, Japan

• Tamio Fujita

  Department of Urology, Nagoya Memorial Hospital, Nagoya, Japan

 We report on two patients, successfully treated by the combination therapy of gemcitabine and 24-h intravenous infusion of cisplatin, who were initially diagnosed with node-positive advanced urothelial cancer. Each patient had a very good clinical response and underwent curative radical surgery after gemcitabine/cisplatin chemotherapy. A microscopically detailed examination of surgically obtained specimens showed the complete disappearance of malignant cells in the two cases. As a pilot study, we have used the regimen of gemcitabine plus 24-h continuous infusion of cisplatin, instead of bolus injection, for the treatment of 20 patients with node-positive or metastatic urothelial cancer. The clinical response rate in this regimen was 75% (complete response 7/20; 35%, partial response 8/20; 40%). The median overall survival was 665 days. As for the adverse effects, the incidences of severe neutropenia and thrombocytopenia (grade 3-4) were 20% and 15%, which might be less toxic than conventional gemcitabine plus cisplatin therapy. The 24-h infusion of cisplatin combined with gemcitabine can be highly recommended as neoadjuvant chemotherapy for locally advanced urothelial cancer.

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