Split dose gemcitabine/ cisplatin (GC) in urothelial carcinoma of the bladder: Review of toxicity and response.

e16018Background: UK guidelines for treatment of bladder cancer recommend Gemcitabine/Cisplatin (GC) or MVAC (Methotrexate, Vinblastine, Doxorubicin and Cisplatin). Outcomes are similar but reported toxicity is less in patients receiving the GC doublet. Most UK centers use 3 weekly cisplatin dosing (70mg/m2). However, split dose Cisplatin weeks 1 and 2 (35mg/m2) with gemcitabine, allows shorter infusion times whilst maintaining efficacy. Methods: We conducted retrospective case note review of patients’ receiving split dose GC for urothelial carcinoma (UC) of the bladder at UCLH since 2009, including radiological and pathological response rates and toxicity assessment during treatment. Results: 58 patients received split dose GC (15 females, 43 males). Median age was 59. 94% were pure UC or had UC as the main histological subtype. 32 patients (55%) were treated neo-adjuvantly. 69% (22/32) are disease free and 78% (25/32) remain alive. 28/32 (87%) completed all 3 planned cycles. Grade 3/4 toxicities were: n...