Chemo choices for advanced bladder cancer - 1257082


Last July my partner of 15 years was diagnosed with stage 4 bladder cancer with mets to the bones. In August 2012 he started chemo - 2 cycles of cisplatin and gemcitabine and then (because of compromised kidney function) 4 cycles of carboplatin and gemcitabine. He had reasonable success with this regime - it shrank the primary tumour, lymph nodes and stopped the mets advancing. Since finishing chemo in December he has been on a trial with lapatinib as maintenance. Unfortunately, a recent scan showed that the cancer was on the move again. There now seems to be several options:
1. To start the carboplatin and gemcitabine again (maybe it will be effective for a short amount of time)
2. To enroll for a two armed clinical trial with either pozaponib (Votrient)or paclitaxel (Taxol)
3. To start carboplatin and paclitaxel.
4. To start gemcitabine and paclitaxel

I was wondering do you have any general research/thoughts on any of these combinations?

Many thanks



Dr West
Posts: 4735

I'm sorry about the progression he's demonstrated. To answer your question, the answer is that there is no research to say which of these approaches would be best. They all have some rationale, and one advantage of participating in a clinical trial is that it may lead to a better sense of an optimal treatment. However, any of these treatments would be a very reasonable option to consider, and I think even a panel of experts would be distributed in their preferences among them.

Good luck.

-Dr. West