B. Neri et al., CYCLOPHOSPHAMIDE, EPIDOXORUBICIN AND CARBOPLATIN AS TREATMENT FOR ADVANCED-CARCINOMA OF THE BLADDER - A PHASE-II STUDY, Oncology Reports, 1(4), 1994, pp. 713-715
In advanced carcinoma of the bladder, the M-VAC chemotherapy schedule
can yield positive results, but at the cost of very high toxicity. Rec
ent studies have shown epidoxorubicin and to a lesser degree, carbopla
tin to be active against urothelial tumors, with cardiac, haematologic
al and renal toxicity lower than that observed with CISCA or M-VAC che
motherapy regimens. In this study, we determined the toxicity and effi
cacy of cyclophosphamide 400 mg/m(2), epidoxorubicin 75 mg/m(2) and ca
rboplatin 300 mg/m(2) in a 28-day course. From February 1990 to Decemb
er 1991, we enrolled 33 advanced bladder cancer patients (25 males, 8
females), mean age 63 years. 31 patients were evaluable for toxicity a
nd response. The major disease localizations were: locoregional 15 (48
%), lymph nodes 6 (20%), liver 5 (16%), lung 3 (10%) and bone 2 (6%).
A total of 186 cycles of therapy were administered, with a mean of 5.4
per patient. Six patients (19%) had a complete response (CR): 2 locor
egional, 3 lymph node and 1 lung. Eleven patients (36%) had a partial
response (PR), for an overall response rate of 55%. The median duratio
n of response was 53 weeks and median survival for the entire group of
patients was 40 weeks. No delays or interruptions due to sepsis occur
red during therapy; haematological, cardiac and renal toxicity were be
low WHO grade 3. The efficacy of this chemotherapy regimen proved to b
e comparable to that of more aggressive schedules, while its toxicity
was markedly lower.