TOXICITY AND RESULTS OF MVAC (METHOTREXATE, VINBLASTINE, ADRIAMYCIN AND CISPLATIN) CHEMOTHERAPY IN ADVANCED UROTHELIAL CARCINOMA

Objective: The experience with MVAC (methotrexate, vinblastine, Adriam ycin and cisplatin) chemotherapy in advanced urothelial cancer is revi ewed with emphasis on toxicity and efficacy. Methods: We report on 28 patients with advanced, progressive transitional cell carcinoma (TCC) of the bladder (27) or ureter (1), treated with MVAC. Results: The ave rage number of cycles was 4.5. Leucopenia was the most frequent and se vere side effect (18% WHO grade I, 46% GII, 19% GII and 4% GIV). Other side effects were acceptable and could be treated successfully. One p atient (complete responder) died of a toxic cause (sepsis), a second p atient (partial responder) died of an intestinal bleeding (not drug- o r cancer-related). Complete response was seen in 10 patients (36%), pa rtial response and stable disease in 4 patients each (14%), progressio n in 8 patients (29%), and 2 patients were not evaluable for response. However, relapses were frequent (8 of 12 remaining responders, 66%). Median survival of the whole group was 9 months (0-52), without a sign ificant difference for responders and nonresponders (p = 0.29). Conclu sion: Our results are comparable to data from the literature with rega rd to efficacy and toxicity, although detailed toxicity data are unfor tunately not always available.