Abstract
Significant toxicities result from the use of MVAC (methotrexate, vinblastine, adriamycin, cisplatin) for advanced/ recurrent transitional cell carcinoma of the bladder (ARTCCB). An alternative regimen of 5-fluorouracil (5-FU) and cisplatin was evaluated by Southwest Oncology Group (SWOG). Thirty-eight patients with ARTCCB were treated with continuous infusion 5-FU 1,000 mg/m2/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 overall response rate of 28% [95% confidence interval (CI) 14-45%]. Median duration of response was 6 months, and median duration of survival was 9 months. No toxic deaths occurred. Grade 4 leukopenia occurred in 5 patients. Other toxicities were mild. Only two documented infections occurred in 5 patients with neutropenia. The response rate of 28% is better than that achieved with cisplatin alone and not dissimilar to the range of response for MVAC. Toxicities were less and tolerable. This regimen will need further evaluation.
Publication types
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Clinical Trial
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Clinical Trial, Phase II
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Multicenter Study
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Research Support, U.S. Gov't, P.H.S.
MeSH terms
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Adult
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Aged
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Aged, 80 and over
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Antimetabolites, Antineoplastic / administration & dosage*
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Antimetabolites, Antineoplastic / adverse effects
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Antineoplastic Agents / administration & dosage*
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Antineoplastic Agents / adverse effects
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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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Bacterial Infections
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Carcinoma, Transitional Cell / drug therapy*
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Cisplatin / administration & dosage*
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Cisplatin / adverse effects
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Female
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Fluorouracil / administration & dosage*
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Fluorouracil / adverse effects
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Follow-Up Studies
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Humans
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Infusions, Intravenous
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Leukopenia / chemically induced
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Male
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Middle Aged
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Neoplasm Recurrence, Local / drug therapy
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Neoplasm Staging
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Neutropenia / chemically induced
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Opportunistic Infections
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Remission Induction
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Survival Rate
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Urinary Bladder Neoplasms / drug therapy*
Substances
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Antimetabolites, Antineoplastic
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Antineoplastic Agents
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Cisplatin
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Fluorouracil