von der Maase Hans
Department of Oncology, Aarhus University Hospital, Denmark.
Expert Rev Anticancer Ther. 2003 Feb;3(1):11-9. doi: 10.1586/14737140.3.1.11.
Gemcitabine has become one of the key drugs in the treatment of patients with locally advanced and metastatic transitional cell carcinoma of the urothelium. The overall response rate for single-agent gemcitabine is 25% with a complete response rate of 9% and toxicity is mild-to-modest. The overall response rate for gemcitabine combined with cisplatin (GC) in Phase II studies is 47% with a complete response rate of 18% and a median survival ranging from 12.5 to 14.3 months. A randomized Phase III study comparing GC and methotrexate, vinblastine, adriamycin and cisplatin (MVAC) has demonstrated similar efficacy with respect to response, time-to-progression and overall survival, whereas GC is associated with less toxicity than MVAC. Thus, GC is now considered a standard of care for patients with locally advanced and metastatic urothelial cancer. Other promising combinations include gemcitabine together with one of the taxanes with or without cisplatin.
吉西他滨已成为治疗局部晚期和转移性尿路上皮移行细胞癌患者的关键药物之一。单药吉西他滨的总缓解率为25%，完全缓解率为9%，毒性为轻度至中度。在II期研究中，吉西他滨联合顺铂（GC）的总缓解率为47%，完全缓解率为18%，中位生存期为12.5至14.3个月。一项比较GC与甲氨蝶呤、长春碱、阿霉素和顺铂（MVAC）的随机III期研究表明，在缓解率、疾病进展时间和总生存期方面疗效相似，而GC的毒性低于MVAC。因此，GC现在被认为是局部晚期和转移性尿路上皮癌患者的标准治疗方案。其他有前景的联合方案包括吉西他滨与一种紫杉烷类药物联合，加或不加顺铂。
