CONTINUOUS-INFUSION 5-FLUOROURACIL AND CISPLATIN FOR ADVANCED RECURRENT TRANSITIONAL-CELL CANCER OF THE BLADDER - A SOUTHWEST-ONCOLOGY-GROUP TRIAL/

Significant toxicities result from the use of MVAC (methotrexate, vinb lastine, adriamycin, cisplatin) for advanced/recurrent transitional ce ll carcinoma of the bladder (ARTCCB). An alternative regimen of 5-fluo rouracil (5-FU) and cisplatin was evaluated by Southwest Oncology Grou p (SWOG). Thirty-eight patients with ARTCCB were treated with continuo us infusion 5-FU 1,000 mg/m(2)/days 1-5 and cisplatin 100 mg/day 1, on a every-21-days schedule. There were two complete responses (CR) and eight partial responses (PR) among 36 eligible patients, for an overal l response rate of 28% [95% confidence interval (CI) 14-45%]. Median d uration of response was 6 months, and median duration of survival was 9 months. No toxic deaths occurred. Grade 4 leukopenia occurred in 5 p atients. Other toxicities were mild. Only two documented infections oc curred in 5 patients with neutropenia. The response rate of 28% is bet ter than that achieved with cisplatin alone and not dissimilar to the range of response for MVAC. Toxicities were less and tolerable. This r egimen will need further evaluation.