vitamin-b-12 and Urethral-Neoplasms

The purpose of this single-center phase II study was to determine the activity of pemetrexed administered as second-line therapy in patients with advanced urothelial carcinoma.. Patients with advanced urothelial carcinoma that had relapsed after receiving perioperative chemotherapy, or progressed on first-line chemotherapy for metastatic disease, were eligible for enrollment. Patients received pemetrexed 500 mg/m(2) every 21 days along with folic acid and vitamin B12 supplementation.. A total of 13 patients were enrolled. An objective response was achieved in 1/12 evaluable patients for an overall response rate of 8% (90% upper limit 29%). This level of activity did not meet criteria for expansion based on the pre-defined optimal 2-stage Simon design and the trial was concluded. Treatment was generally well tolerated, however, 2/13 patients developed febrile neutropenia. Non-hematologic grade > or = 3 toxicity was rare.. Pemetrexed as second-line therapy in advanced urothelial carcinoma is associated with modest activity. The role of this novel antifolate in chemotherapy-naïve patients warrants further investigation.

Topics: Administration, Oral; Antimetabolites, Antineoplastic; Carcinoma, Transitional Cell; Drug Administration Schedule; Folic Acid; Glutamates; Guanine; Humans; Infusions, Intravenous; Pelvic Neoplasms; Pemetrexed; Salvage Therapy; Treatment Outcome; Urethral Neoplasms; Urinary Bladder Neoplasms; Urothelium; Vitamin B 12; Vitamin B Complex

Topics: Ascorbic Acid; Blood Transfusion; Brazil; Breast Neoplasms; Cyclophosphamide; Female; Humans; Neoplasms; Ovarian Neoplasms; Thyroid Hormones; Urethral Neoplasms; Uterine Cervical Neoplasms; Vaginal Neoplasms; Vitamin B 12; Vitamin B Complex