SYSTEMIC CHEMOTHERAPY FOR ADVANCED BLADDER-CARCINOMA - CLINICAL AND EXPERIMENTAL RESULTS

The influence of systemic chemotherapy on advanced bladder carcinoma i s limited. Apparently patients do not benefit from cytostatic treatmen t prior to surgical removal of the bladder (neoadjuvant chemotherapy). Combination chemotherapy subsequent to radical cystectomy is currentl y being investigated in several clinical trials; at present, however, adjuvant chemotherapy cannot be regarded as standard treatment. In met astatic disease, responses following application of cisplatin and meth otrexate were observed in approximately 50% of the patients without si gnificantly influencing cure. Regarding the progress in surgical techn iques including continent urinary diversion, improvement of chemothera py through basic resarch and development of new cytotoxic agents and n ovel combination regimens is mandatory. We present the results of two clinical phase-ii-trials with mitomycin C, 5-fluorouracil, and folinic acid as well as taxol, carboplatin, and acellular pertussis vaccine f or cisplatin and methotrexate refractory metastatic bladder carcinoma.