CARBOPLATIN, METHOTREXATE, VINBLASTINE AND EPIRUBICIN (CARBO-MVE) FORTRANSITIONAL CELL BLADDER-CARCINOMA

Background: MVAC is considered the most effective chemotherapy regimen for transitional cell bladder carcinoma. However, due to its signific ant toxic effects we substituted carboplatin for cisplatin and epirubi cin for adriamycin in an attempt to produce the same response with les s toxicity. Patients and methods: Twenty-seven patients with invasive transitional cell bladder carcinoma received Carbo-MVE: carboplatin (3 00 mgr/m2 d2), methotrexate (30 Mgr/M2 dl, 15, 22), vinblastine (3 mgr /m2 d2, 15, 22) and epirubicin (30 mgr/M2 d2) every 4 weeks. Results: There were 2 complete clinical responses (8.4%), 5 partial clinical re sponses (20.8%), 8 stabilizations (33.3%) and 9 progressions (37.5%). The overall clinical response rate was 29.2% (11%-47.4%, 95% CI), but 2 partial clinical remissions were not pathologically confirmed; were they to be considered as non-responses the response rate would fall ev en lower (20.8%). Toxicity was moderately severe, with 77.8% developin g WHO grade III-IV granulocytopenia, 22.2% grade III-IV thrombocytopen ia and 59.3% grade II-III vomiting. There were no toxic deaths nor any renal toxicity. Conclusions: Our results suggest that Carbo-MVE is le ss active and at least as hematotoxic as multiagent CDDP-based regimen s.