paclitaxel + ifosfamide + carboplatin + gemcitabine

This combination chemotherapy regimen, often referred to as the PIG-C regimen, consists of the taxane paclitaxel, the alkylating agent ifosfamide, the platinum-based antineoplastic carboplatin, and the nucleoside analog gemcitabine. It was specifically evaluated by the Tulane University Health Sciences Center in a Phase II clinical trial (NCT00005835) as an adjuvant treatment for patients with high-risk transitional cell carcinoma of the urothelium (TCCU) following radical surgery. The regimen leverages synergistic mechanisms of action: paclitaxel stabilizes microtubules to inhibit mitosis; ifosfamide and carboplatin induce DNA damage through alkylation and cross-linking; and gemcitabine acts as an antimetabolite that inhibits DNA synthesis. The goal of this intensive four-drug combination is to eradicate residual micrometastatic disease and improve survival outcomes in patients with locally advanced or node-positive urothelial cancer.

Other names

PIG-C regimenAdjuvant paclitaxel, ifosfamide, carboplatin, and gemcitabinegemcitabine-Tulane University Health Sciences Center-transitional cell carcinoma of the urothelium