Oudard S et al. (2007) Prospective multicenter phase II study of gemcitabine plus platinum salt for metastatic collecting duct carcinoma: results of a GETUG (Groupe d'Etudes des Tumeurs Uro-Génitales) study. J Urol 177: 1698–1702

Collecting duct carcinoma (CDC) is a rare renal cancer that is usually metastatic at initial presentation. Radical nephrectomy, radiotherapy and immunotherapy are all ineffective for treatment of metastatic cases, so chemotherapy has been suggested. The standard first-line therapy for metastatic urothelial cancer (gemcitabine plus cisplatin) holds promise because the histology of CDC is similar to that of urothelial carcinoma, but prospective evidence of a response in CDC cases was lacking.

Oudard et al. conducted a prospective, phase II study evaluating the efficacy and safety of gemcitabine plus platinum salt in 23 chemotherapy-naive patients with metastatic CDC; 19 had ≥2 metastases. Patients (median age 65 years [range 18–74 years]) were enrolled from six French centers between 2001 and 2005. Drugs (gemcitabine 1,250 mg/m2 on days 1 and 8, cisplatin or carboplatin [for renally insufficient patients] on day 1) were administered every 3 weeks for a median six cycles; adjustments depended on the level of toxic effects.

Objective response rate was 26% (one patient had a complete response and five had a partial response). The safety profile of the therapy was acceptable; there were no treatment-related deaths and toxicity was mainly hematological.

Gemcitabine plus platinum salts should be considered as standard first-line therapy for patients with metastatic CDC.