Clinical study of combination chemotherapy of methotrexate, epirubicin and nedaplatin (MEN) in patients with advanced urothelial carcinoma

摘要

The toxicity of platinum-based chemotherapies is a common problem for patients with advanced urothelial carcinoma. We performed a prospective study to assess the efficacy and safety of the combination chemotherapy of methotrexate, epirubicin and nedaplatin (MEN) as first-line treatment in patients with advanced urothelial carcinoma. Eligible patients had pathologically proven measurable unresectable or metastatic urothelial carcinoma. Between February 2003 and February 2006, 11 patients with a mean age of 70 years were treated every 3 weeks with methotrexate (30 mg/m(2) on day 1) and epirubicin (50 mg/m(2) on day 1) and nedaplatin (80 mg/m(2) on day 2). A median of 2.6 cycles were administered. None of the 11 patients achieved a complete response (CR), but 6 patients (55%) achieved a partial response (PR) with a median duration of response of 10 months, and no responses occurred in 4 patients. The median survival time was 11 months. Grade 4 hematological toxicities included neutropenia in 1 case (9%), thrombocytopenia in 2 cases (19%) and anemia in 1 case (9%). None of the 11 patients had febrile neutropenic episodes, and no toxic death was observed. Our results suggest that the combination chemotherapy of methotrexate, epirubicin and nedaplatin (MEN) was effective and acceptable treatment in patients with advanced urothelial carcinoma.