Combination Chemotherapy of Docetaxel, Ifosfamide and Cisplatin (DIP) in Patients with Metastatic Urothelial Cancer:

Objective: The aim of this study was to evaluate the efficacy and toxicity of a new combination chemotherapy of docetaxel, ifosfamideand cisplatin (DIP) in the treatment ofmetastatic urothelial cancer. Methods: Fourteen patients (nine male and five female; aged 59–82 years) with metastatic urothelial carcinoma, including five patients who have a history of methotrexate, vinblastine, doxorubicin and cisplatin (MVAC) chemotherapies, received the combination of docetaxel 60 mg/m2 on day 1, and ifosfamide 1.0 g/m2 and cisplatin 20 mg/m2 on days 2–6 and repeated every 21 days, to a maximum of six cycles. Eligibility criteria included performance status (World HealthOrganization) 0–3; normal bonemarrow and liver function; and no symptomatic peripheral neuropathy. Results: Ten of the 14 patients (72%) demonstrated a partial response (PR), with durations of response ranging from 3 to 12 months [median 6.5 months; 95 % confidence interval (CI), 4.1– 8.7 months]. The response rate of the five patients with MVAC-refractory cancer was 80 % with median duration of response 5.5 months, comparable with that of the cases without previous MVAC therapies. Grade 3–4 granulocytopenia occurred in 10 cases (71%), resulting in three episodes (21%) of febrile neutropenia. Grade 3 thrombocytopenia was observed in five cases (36%). No toxic death was observed. Grade 2 peripheral neuropathy was identified in one case. Conclusions: This pilot study demonstrated that DIP is an effective regimen for the treatment of metastatic urothelial cancer, and warrants further investigation. Key words: docetaxel – ifosfamide – cisplatin – metastatic urothelial cance