Abstract
M-VAC (cisplatin, methotrexate, adriamycin, vinblastine) combination chemotherapy has been for long time the standard of care in fit patient with advanced urothelial tumors. Gemcitabine/cisplatin with similar results and an improved toxicity profile has proved to be a new standard alternative. Whether or not we can improve survival with newer triplet regimens will depend upon the results of ongoing phase III trials. In addition to the new active drug combinations and targeted therapies, new approaches are emerging for treatment. Chemotherapy optimization using molecular markers predicting chemosensitivity are being applied. There is an obvious need to incorporate in clinical trials a systematic translational approach to explain both our successes and our failures.
Publication types
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Comparative Study
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Evaluation Study
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Review
MeSH terms
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Aged
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Antimetabolites, Antineoplastic / administration & dosage
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Antimetabolites, Antineoplastic / 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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Biomarkers, Tumor / analysis
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Carboplatin / administration & dosage
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Carboplatin / adverse effects
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Carcinoma, Transitional Cell / complications
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Carcinoma, Transitional Cell / diagnosis
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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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Comorbidity
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Deoxycytidine / administration & dosage
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Deoxycytidine / 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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Gemcitabine
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Humans
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Methotrexate / administration & dosage
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Methotrexate / adverse effects
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Pharmacogenetics
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Prognosis
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Renal Insufficiency / complications
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Urinary Bladder Neoplasms / complications
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Urinary Bladder Neoplasms / diagnosis
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Urinary Bladder Neoplasms / drug therapy*
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Urinary Bladder Neoplasms / pathology
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Urothelium / 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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Biomarkers, Tumor
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Deoxycytidine
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Vinblastine
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Doxorubicin
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Carboplatin
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Cisplatin
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Methotrexate
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Gemcitabine