Does Adding Paclitaxel to Chemotherapy Improve Urothelial Cancer Outcomes?

Advanced transitional cell cancer (TCC) of the urothelium is a highly aggressive epithelial cancer that commonly manifests in older patients, many of whom have extensive medical comorbidities. Cisplatin-based chemotherapy has moderate to significant activity against this disease; about 50% of patients achieve objective response, and 5% to 15% (primarily those with nodal metastatic disease) are likely cured. Although cisplatin-based therapy can be given only to patients who are “fit” enough (i.e., those with adequate performance status and renal function), efforts are ongoing to improve the current optimal therapies: methotrexate, vinblastine, doxorubicin, and cisplatin (MVAC) or gemcitabine and cisplatin (GC).

Given that paclitaxel plus GC (…