Abstract
The combination of methotrexate, vinblastine, Adriamycin, and cisplatin (MVAC) has been the standard therapy for transitional cell carcinoma for over a decade. Despite evidence that MVAC can improve outcome in comparison with single drugs or other combinations in this disease, only a small fraction of patients (less than 4%) become long-term survivors, and the regimen is quite toxic. Attempts to improve upon the MVAC regimen have partially ameliorated its toxicity, but they have not clearly improved outcome. Recently, a number of new chemotherapeutic agents have become available. This report summarizes the current experience with these agents and combinations.
MeSH terms
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Antimetabolites, Antineoplastic / therapeutic use
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Antineoplastic Agents, Phytogenic / therapeutic use
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Antineoplastic Combined Chemotherapy Protocols / administration & dosage
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Antineoplastic Combined Chemotherapy Protocols / adverse effects
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Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
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Bridged-Ring Compounds / therapeutic use
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Carcinoma, Transitional Cell / drug therapy*
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Carcinoma, Transitional Cell / pathology
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Cisplatin / administration & dosage
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Cisplatin / adverse effects
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Deoxycytidine / analogs & derivatives
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Deoxycytidine / therapeutic use
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Doxorubicin / administration & dosage
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Doxorubicin / adverse effects
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Gallium / therapeutic use
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Gemcitabine
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Humans
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Ifosfamide / therapeutic use
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Methotrexate / administration & dosage
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Methotrexate / adverse effects
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Neoplasm Metastasis
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Taxoids*
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Urinary Bladder Neoplasms / drug therapy*
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Urinary Bladder Neoplasms / pathology
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Vinblastine / administration & dosage
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Vinblastine / adverse effects
Substances
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Antimetabolites, Antineoplastic
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Antineoplastic Agents, Phytogenic
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Bridged-Ring Compounds
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Taxoids
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Deoxycytidine
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taxane
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Vinblastine
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Doxorubicin
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Gallium
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Cisplatin
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Ifosfamide
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gallium nitrate
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Methotrexate
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Gemcitabine