Trial Outcomes & Findings for Gemcitabine and Cisplatin as Neoadjuvant Chemotherapy in Patients With High-Grade Upper Tract Urothelial Carcinoma (NCT NCT01261728)

NCT ID: NCT01261728

Last Updated: 2026-09-02

Results Overview

of neoadjuvant Gemcitabine and Cisplatin/GC regimen in patients with upper tract high-grade urothelial carcinoma. Pathologic response to neoadjuvant GC is defined as the absence of high-grade carcinoma (\<pT2 disease) and the absence of microscopic lymph node metastases (N0) on the final nephroureterectomy specimen.

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

57 participants

Primary outcome timeframe

up to 2 years

Results posted on

2026-09-02

Participant Flow

Participant milestones

Participant milestones
Measure
Gemcitabine and Cisplatin
This is a Phase II Study of Gemcitabine and Cisplatin (GC) as neoadjuvant chemotherapy in patients with upper tract high-grade urothelial carcinoma who are candidates for radical nephroureterectomy or distal ureterectomy. Gemcitabine and Cisplatin: Patients will receive four cycles of GC administered every 21 days. Gemcitabine 1,000 mg/m2 and Cisplatin 35 mg/m2 will be administered intravenously on days 1 and 8. A total of four cycles of therapy will be administered at 21 day intervals followed by radical nephroureterectomy or distal ureterectomy.
Overall Study
STARTED
57
Overall Study
COMPLETED
57
Overall Study
NOT COMPLETED
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Gemcitabine and Cisplatin as Neoadjuvant Chemotherapy in Patients With High-Grade Upper Tract Urothelial Carcinoma

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Gemcitabine and Cisplatin
n=57 Participants
This is a Phase II Study of Gemcitabine and Cisplatin (GC) as neoadjuvant chemotherapy in patients with upper tract high-grade urothelial carcinoma who are candidates for radical nephroureterectomy or distal ureterectomy. Gemcitabine and Cisplatin: Patients will receive four cycles of GC administered every 21 days. Gemcitabine 1,000 mg/m2 and Cisplatin 35 mg/m2 will be administered intravenously on days 1 and 8. A total of four cycles of therapy will be administered at 21 day intervals followed by radical nephroureterectomy or distal ureterectomy.
Age, Continuous
66 years
n=136 Participants
Sex: Female, Male
Female
21 Participants
n=136 Participants
Sex: Female, Male
Male
36 Participants
n=136 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
11 Participants
n=136 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
43 Participants
n=136 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
3 Participants
n=136 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=136 Participants
Race (NIH/OMB)
Asian
1 Participants
n=136 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=136 Participants
Race (NIH/OMB)
Black or African American
2 Participants
n=136 Participants
Race (NIH/OMB)
White
54 Participants
n=136 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=136 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=136 Participants
Region of Enrollment
United States
57 Participants
n=136 Participants

PRIMARY outcome

Timeframe: up to 2 years

of neoadjuvant Gemcitabine and Cisplatin/GC regimen in patients with upper tract high-grade urothelial carcinoma. Pathologic response to neoadjuvant GC is defined as the absence of high-grade carcinoma (\<pT2 disease) and the absence of microscopic lymph node metastases (N0) on the final nephroureterectomy specimen.

Outcome measures

Outcome measures
Measure
Gemcitabine and Cisplatin
n=57 Participants
This is a Phase II Study of Gemcitabine and Cisplatin (GC) as neoadjuvant chemotherapy in patients with upper tract high-grade urothelial carcinoma who are candidates for radical nephroureterectomy or distal ureterectomy. Gemcitabine and Cisplatin: Patients will receive four cycles of GC administered every 21 days. Gemcitabine 1,000 mg/m2 and Cisplatin 35 mg/m2 will be administered intravenously on days 1 and 8. A total of four cycles of therapy will be administered at 21 day intervals followed by radical nephroureterectomy or distal ureterectomy.
Pathologic Response Rate (<pT2)
Met the end point of pathologic response
36 Participants
Pathologic Response Rate (<pT2)
Did not meet the end point of pathologic response
21 Participants

SECONDARY outcome

Timeframe: 2 years

will be estimated using the methods of Kaplan and Meier in patients with upper tract high-grade urothelial carcinoma with neoadjuvant GC followed by radical nephroureterectomy.

Outcome measures

Outcome measures
Measure
Gemcitabine and Cisplatin
n=57 Participants
This is a Phase II Study of Gemcitabine and Cisplatin (GC) as neoadjuvant chemotherapy in patients with upper tract high-grade urothelial carcinoma who are candidates for radical nephroureterectomy or distal ureterectomy. Gemcitabine and Cisplatin: Patients will receive four cycles of GC administered every 21 days. Gemcitabine 1,000 mg/m2 and Cisplatin 35 mg/m2 will be administered intravenously on days 1 and 8. A total of four cycles of therapy will be administered at 21 day intervals followed by radical nephroureterectomy or distal ureterectomy.
Percentage of Participants With Progression Free Survival Rate
89 percentage of participants
Interval 81.0 to 98.0

SECONDARY outcome

Timeframe: 2 years

will be estimated using the methods of Kaplan and Meier in patients with upper tract high-grade urothelial carcinoma treated with neoadjuvant GC followed by radical nephroureterectomy.

Outcome measures

Outcome measures
Measure
Gemcitabine and Cisplatin
n=57 Participants
This is a Phase II Study of Gemcitabine and Cisplatin (GC) as neoadjuvant chemotherapy in patients with upper tract high-grade urothelial carcinoma who are candidates for radical nephroureterectomy or distal ureterectomy. Gemcitabine and Cisplatin: Patients will receive four cycles of GC administered every 21 days. Gemcitabine 1,000 mg/m2 and Cisplatin 35 mg/m2 will be administered intravenously on days 1 and 8. A total of four cycles of therapy will be administered at 21 day intervals followed by radical nephroureterectomy or distal ureterectomy.
Overall Survival
Participants who died
11 Participants
Overall Survival
Participants who did not die
46 Participants

SECONDARY outcome

Timeframe: 2 years

of neoadjuvant Gemcitabine and Cisplatin in this setting. Toxicity will be graded according to the National Cancer Institute Common Toxicity Criteria version 4.0.

Outcome measures

Outcome measures
Measure
Gemcitabine and Cisplatin
n=57 Participants
This is a Phase II Study of Gemcitabine and Cisplatin (GC) as neoadjuvant chemotherapy in patients with upper tract high-grade urothelial carcinoma who are candidates for radical nephroureterectomy or distal ureterectomy. Gemcitabine and Cisplatin: Patients will receive four cycles of GC administered every 21 days. Gemcitabine 1,000 mg/m2 and Cisplatin 35 mg/m2 will be administered intravenously on days 1 and 8. A total of four cycles of therapy will be administered at 21 day intervals followed by radical nephroureterectomy or distal ureterectomy.
Number of Participants Evaluated for Toxicity
57 Participants

Adverse Events

Gemcitabine and Cisplatin

Serious events: 22 serious events
Other events: 57 other events
Deaths: 11 deaths

Serious adverse events

Serious adverse events
Measure
Gemcitabine and Cisplatin
n=57 participants at risk
This is a Phase II Study of Gemcitabine and Cisplatin (GC) as neoadjuvant chemotherapy in patients with upper tract high-grade urothelial carcinoma who are candidates for radical nephroureterectomy or distal ureterectomy. Gemcitabine and Cisplatin: Patients will receive four cycles of GC administered every 21 days. Gemcitabine 1,000 mg/m2 and Cisplatin 35 mg/m2 will be administered intravenously on days 1 and 8. A total of four cycles of therapy will be administered at 21 day intervals followed by radical nephroureterectomy or distal ureterectomy.
Blood and lymphatic system disorders
Febrile Neutropenia
7.0%
4/57 • 2 years
Blood and lymphatic system disorders
Anemia
5.3%
3/57 • 2 years
Blood and lymphatic system disorders
Thrombotic thrombocytopenic purpura
1.8%
1/57 • 2 years
Gastrointestinal disorders
Nausea
1.8%
1/57 • 2 years
General disorders
Pain
1.8%
1/57 • 2 years
Infections and infestations
Lung Infection
1.8%
1/57 • 2 years
Investigations
Lymphocyte count decreased
33.3%
19/57 • 2 years
Investigations
Neutrophil count decrease
31.6%
18/57 • 2 years
Investigations
WBC decreased
7.0%
4/57 • 2 years
Investigations
Platelet count decreased
7.0%
4/57 • 2 years
Investigations
Creatinine increased
5.3%
3/57 • 2 years
Investigations
ALT increased
3.5%
2/57 • 2 years
Investigations
Activated partial thomboplastin time prolonged
1.8%
1/57 • 2 years
Investigations
Lipase increased
1.8%
1/57 • 2 years
Investigations
Serum amylase increased
1.8%
1/57 • 2 years
Metabolism and nutrition disorders
Hyperglycemia
14.0%
8/57 • 2 years
Metabolism and nutrition disorders
Hypocalcemia
7.0%
4/57 • 2 years
Metabolism and nutrition disorders
Hyponatremia
5.3%
3/57 • 2 years
Metabolism and nutrition disorders
Hypokalemia
5.3%
3/57 • 2 years
Metabolism and nutrition disorders
Hyperkalemia
3.5%
2/57 • 2 years
Metabolism and nutrition disorders
Hypophosphatemia
3.5%
2/57 • 2 years
Metabolism and nutrition disorders
Anorexia
1.8%
1/57 • 2 years
Metabolism and nutrition disorders
Dehydration
1.8%
1/57 • 2 years
Musculoskeletal and connective tissue disorders
Generalized muscle weakness
1.8%
1/57 • 2 years
Skin and subcutaneous tissue disorders
Erythema multiforme
1.8%
1/57 • 2 years
Vascular disorders
Thromboembolic event
7.0%
4/57 • 2 years
Vascular disorders
Hypotension
1.8%
1/57 • 2 years

Other adverse events

Other adverse events
Measure
Gemcitabine and Cisplatin
n=57 participants at risk
This is a Phase II Study of Gemcitabine and Cisplatin (GC) as neoadjuvant chemotherapy in patients with upper tract high-grade urothelial carcinoma who are candidates for radical nephroureterectomy or distal ureterectomy. Gemcitabine and Cisplatin: Patients will receive four cycles of GC administered every 21 days. Gemcitabine 1,000 mg/m2 and Cisplatin 35 mg/m2 will be administered intravenously on days 1 and 8. A total of four cycles of therapy will be administered at 21 day intervals followed by radical nephroureterectomy or distal ureterectomy.
Skin and subcutaneous tissue disorders
Papulopustular rash
1.8%
1/57 • 2 years
Nervous system disorders
Peripheral motor neuropathy
3.5%
2/57 • 2 years
Nervous system disorders
Peripheral sensory neuropathy
31.6%
18/57 • 2 years
Vascular disorders
Phlebitis
24.6%
14/57 • 2 years
Blood and lymphatic system disorders
Platelet count decreased
71.9%
41/57 • 2 years
Respiratory, thoracic and mediastinal disorders
Pleuritic pain
1.8%
1/57 • 2 years
Respiratory, thoracic and mediastinal disorders
Postnasal drip
3.5%
2/57 • 2 years
Investigations
Proteinuria
1.8%
1/57 • 2 years
Skin and subcutaneous tissue disorders
Pruritus
7.0%
4/57 • 2 years
Skin and subcutaneous tissue disorders
Rash
5.3%
3/57 • 2 years
Skin and subcutaneous tissue disorders
Rash acneiform
12.3%
7/57 • 2 years
Skin and subcutaneous tissue disorders
Rash maculo-papular
19.3%
11/57 • 2 years
Skin and subcutaneous tissue disorders
Rash pustular
1.8%
1/57 • 2 years
Gastrointestinal disorders
Rectal pain
1.8%
1/57 • 2 years
Renal and urinary disorders
Renal disorder
1.8%
1/57 • 2 years
Infections and infestations
Rhinitis infective
1.8%
1/57 • 2 years
Investigations
Serum amylase increased
1.8%
1/57 • 2 years
Infections and infestations
Sinusitis
1.8%
1/57 • 2 years
Skin and subcutaneous tissue disorders
Skin hyperpigmentation
1.8%
1/57 • 2 years
Infections and infestations
Skin infection
1.8%
1/57 • 2 years
Respiratory, thoracic and mediastinal disorders
Sore throat
3.5%
2/57 • 2 years
Gastrointestinal disorders
Stomach pain
1.8%
1/57 • 2 years
Vascular disorders
Superficial thrombophlebitis
1.8%
1/57 • 2 years
Vascular disorders
Thromboembolic event
15.8%
9/57 • 2 years
Blood and lymphatic system disorders
Thrombotic thrombocytopenic purpura
1.8%
1/57 • 2 years
Ear and labyrinth disorders
Tinnitus
28.1%
16/57 • 2 years
Gastrointestinal disorders
Toothache
1.8%
1/57 • 2 years
Infections and infestations
Upper respiratory infection
1.8%
1/57 • 2 years
Renal and urinary disorders
Urinary frequency
47.4%
27/57 • 2 years
Renal and urinary disorders
Urinary incontinence
12.3%
7/57 • 2 years
Infections and infestations
Urinary tract infection
3.5%
2/57 • 2 years
Renal and urinary disorders
Urinary retention
1.8%
1/57 • 2 years
Renal and urinary disorders
Urinary tract pain
28.1%
16/57 • 2 years
Renal and urinary disorders
Urinary urgency
1.8%
1/57 • 2 years
Reproductive system and breast disorders
Vaginal dryness
3.5%
2/57 • 2 years
Injury, poisoning and procedural complications
Vascular access complication
1.8%
1/57 • 2 years
Respiratory, thoracic and mediastinal disorders
Voice alteration
1.8%
1/57 • 2 years
Gastrointestinal disorders
Vomiting
5.3%
3/57 • 2 years
Eye disorders
Watering eyes
3.5%
2/57 • 2 years
Investigations
Weight gain
3.5%
2/57 • 2 years
Investigations
Weight loss
10.5%
6/57 • 2 years
Investigations
White blood cell decreased
78.9%
45/57 • 2 years
Nervous system disorders
Dizziness
8.8%
5/57 • 2 years
Eye disorders
Dry eye
3.5%
2/57 • 2 years
Gastrointestinal disorders
Dry mouth
8.8%
5/57 • 2 years
Skin and subcutaneous tissue disorders
Dry Skin
7.0%
4/57 • 2 years
Nervous system disorders
Dysgeusia
19.3%
11/57 • 2 years
Gastrointestinal disorders
Dyspepsia
15.8%
9/57 • 2 years
Gastrointestinal disorders
Dysphagia
3.5%
2/57 • 2 years
Respiratory, thoracic and mediastinal disorders
Dyspnea
36.8%
21/57 • 2 years
General disorders
Edema limbs
19.3%
11/57 • 2 years
General disorders
Edema trunk
1.8%
1/57 • 2 years
Respiratory, thoracic and mediastinal disorders
Epistaxis
3.5%
2/57 • 2 years
Skin and subcutaneous tissue disorders
Erythema multiforme
1.8%
1/57 • 2 years
General disorders
Fatigue
84.2%
48/57 • 2 years
Blood and lymphatic system disorders
Febrile neutropenia
7.0%
4/57 • 2 years
General disorders
Fever
7.0%
4/57 • 2 years
Musculoskeletal and connective tissue disorders
Flank pain
5.3%
3/57 • 2 years
Gastrointestinal disorders
Flatulence
3.5%
2/57 • 2 years
Eye disorders
Floaters
1.8%
1/57 • 2 years
General disorders
Gait disturbance
3.5%
2/57 • 2 years
Gastrointestinal disorders
Gastroesophageal reflux disease
10.5%
6/57 • 2 years
Musculoskeletal and connective tissue disorders
Generalized muscle weakness
14.0%
8/57 • 2 years
Nervous system disorders
Headache
33.3%
19/57 • 2 years
Ear and labyrinth disorders
Hearing impaired
1.8%
1/57 • 2 years
Cardiac disorders
Heart failure
1.8%
1/57 • 2 years
Vascular disorders
Hematoma
3.5%
2/57 • 2 years
Renal and urinary disorders
Hematuria
26.3%
15/57 • 2 years
Investigations
Hemoglobin increased
5.3%
3/57 • 2 years
Gastrointestinal disorders
Hemorrhoids
1.8%
1/57 • 2 years
Respiratory, thoracic and mediastinal disorders
Hiccups
5.3%
3/57 • 2 years
Respiratory, thoracic and mediastinal disorders
Hoarseness
1.8%
1/57 • 2 years
Metabolism and nutrition disorders
Hypercalcemia
3.5%
2/57 • 2 years
Metabolism and nutrition disorders
Hyperglycemia
93.0%
53/57 • 2 years
Skin and subcutaneous tissue disorders
Hyperhidrosis
1.8%
1/57 • 2 years
Metabolism and nutrition disorders
Hyperkalemia
40.4%
23/57 • 2 years
Metabolism and nutrition disorders
Hypernatremia
8.8%
5/57 • 2 years
Vascular disorders
Hypertension
3.5%
2/57 • 2 years
Metabolism and nutrition disorders
Hypertriglyceridemia
19.3%
11/57 • 2 years
Metabolism and nutrition disorders
Hypoalbuminemia
63.2%
36/57 • 2 years
Metabolism and nutrition disorders
Hypocalcemia
78.9%
45/57 • 2 years
Metabolism and nutrition disorders
Hypoglycemia
14.0%
8/57 • 2 years
Metabolism and nutrition disorders
Hypokalemia
14.0%
8/57 • 2 years
Metabolism and nutrition disorders
Hypomagnesemia
52.6%
30/57 • 2 years
Metabolism and nutrition disorders
Hyponatremia
33.3%
19/57 • 2 years
Metabolism and nutrition disorders
Hypophosphatemia
10.5%
6/57 • 2 years
Vascular disorders
Hypotension
1.8%
1/57 • 2 years
Endocrine disorders
Hypothyroidism
1.8%
1/57 • 2 years
Injury, poisoning and procedural complications
Infusion related reaction
1.8%
1/57 • 2 years
Injury, poisoning and procedural complications
Injection site reaction
5.3%
3/57 • 2 years
Investigations
INR increased
21.1%
12/57 • 2 years
Psychiatric disorders
Insomnia
14.0%
8/57 • 2 years
Nervous system disorders
Lethargy
1.8%
1/57 • 2 years
Investigations
Lipase increased
1.8%
1/57 • 2 years
General disorders
Localized edema
1.8%
1/57 • 2 years
Infections and infestations
Lung infection
1.8%
1/57 • 2 years
Investigations
Lymphocyte count decreased
49.1%
28/57 • 2 years
General disorders
Malaise
1.8%
1/57 • 2 years
Gastrointestinal disorders
Mucositis oral
15.8%
9/57 • 2 years
Musculoskeletal and connective tissue disorders
Muscle weakness lower limb
1.8%
1/57 • 2 years
Musculoskeletal and connective tissue disorders
Myalgia
8.8%
5/57 • 2 years
Respiratory, thoracic and mediastinal disorders
Nasal congestion
10.5%
6/57 • 2 years
Gastrointestinal disorders
Nausea
50.9%
29/57 • 2 years
Musculoskeletal and connective tissue disorders
Neck pain
5.3%
3/57 • 2 years
Investigations
Neutrophil count decreased
63.2%
36/57 • 2 years
General disorders
Non-cardiac chest pain
3.5%
2/57 • 2 years
General disorders
Pain
21.1%
12/57 • 2 years
Musculoskeletal and connective tissue disorders
Pain in extremity
1.8%
1/57 • 2 years
Skin and subcutaneous tissue disorders
Pain of skin
1.8%
1/57 • 2 years
Skin and subcutaneous tissue disorders
Palmar-plantar erythrodysesthesia syndrome
1.8%
1/57 • 2 years
Cardiac disorders
Palpitations
3.5%
2/57 • 2 years
Gastrointestinal disorders
Pancreatitis
1.8%
1/57 • 2 years
Musculoskeletal and connective tissue disorders
Arthralgia
8.8%
5/57 • 2 years
Injury, poisoning and procedural complications
Aspartate aminotransferase increased
29.8%
17/57 • 2 years
Musculoskeletal and connective tissue disorders
Back pain
21.1%
12/57 • 2 years
Infections and infestations
Bladder infection
1.8%
1/57 • 2 years
Gastrointestinal disorders
Bloating
5.3%
3/57 • 2 years
Investigations
Blood bilirubin increased
12.3%
7/57 • 2 years
Eye disorders
Blurred vision
7.0%
4/57 • 2 years
Cardiac disorders
Cardiac
1.8%
1/57 • 2 years
Cardiac disorders
Chest pain - cardiac
3.5%
2/57 • 2 years
General disorders
Chills
3.5%
2/57 • 2 years
Investigations
Cholesterol high
15.8%
9/57 • 2 years
Gastrointestinal disorders
Colitis
1.8%
1/57 • 2 years
Nervous system disorders
Concentration impairment
1.8%
1/57 • 2 years
Infections and infestations
Conjunctivitis
1.8%
1/57 • 2 years
Gastrointestinal disorders
Constipation
52.6%
30/57 • 2 years
Respiratory, thoracic and mediastinal disorders
Cough
28.1%
16/57 • 2 years
Investigations
Creatinine increased
73.7%
42/57 • 2 years
Renal and urinary disorders
Cystitis noninfective
1.8%
1/57 • 2 years
Metabolism and nutrition disorders
Dehydration
1.8%
1/57 • 2 years
Psychiatric disorders
Depression
1.8%
1/57 • 2 years
Gastrointestinal disorders
Diarrhea
15.8%
9/57 • 2 years
Gastrointestinal disorders
Abdominal pain
8.8%
5/57 • 2 years
Investigations
Activated partial thromboplastin time prolonged
21.1%
12/57 • 2 years
Renal and urinary disorders
Acute kidney injury
1.8%
1/57 • 2 years
Investigations
Alanine aminotransferase increased
42.1%
24/57 • 2 years
Investigations
Alkaline phosphatase increased
21.1%
12/57 • 2 years
Respiratory, thoracic and mediastinal disorders
Allergic rhinitis
7.0%
4/57 • 2 years
Skin and subcutaneous tissue disorders
Alopecia
26.3%
15/57 • 2 years
Blood and lymphatic system disorders
Anemia
10.5%
6/57 • 2 years
Metabolism and nutrition disorders
Anorexia
8.8%
5/57 • 2 years
Psychiatric disorders
Anxiety
14.0%
8/57 • 2 years

Additional Information

Dr. Jonathan Coleman, MD

Memorial Sloan Kettering Cancer Center

Phone: 646-422-4432

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place