From 1990 to 1992, 15 patients with advanced transitional cell cancer, previously untreated with chemotherapy, were treated with intensified M-VAC: methotrexate 30 mg/m2 day 1 and 15, vinblastine 3 mg/m2 day 2 and 15, adriamycin 30 mg/m2 and cisplatin 100 mg/m2 days 2→5 for a maximum of 4 cycles. Non-responders to the first 2 cycles of therapy were excluded; the partial-responder patients underwent surgical treatment of the residual disease, whenever possible. Three complete responses (20%) and 11 partial responses (73%) were observed. This regimen showed apparent benefit over classic M-VAC.
SternbergC.N., YagodaA., ScherHl., WatsonR.C., GellerN., HerrH.W., MorseM.J., SoganiP.C., VaughanE.D., BandeN., WeiselbergL., RosadoK., SmartT., Shiow-YunLin, PenembergD., FairW.R., WhitmoreW.F.: Methotrexate, vinblastine, doxorubicin and cisplatin for advanced transitional cell carcinoma of the urothelium: efficacy and patterns of response and relapse. Cancer 64: 2448–2458, 1989.
2.
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LoehrerP.J., EinhornL.H., ElsonP.: A randomized comparison of cisplatin alone or in combination with methotrexate, vinblastine and doxorubicin in patients with metastatic urothelial carcinoma. A cooperative group study. J. Clin Oncol., 10: 1066–1073, 1992.
5.
LongothetisC.J., DexeusF.H., FinnL., SellaA., AmatoR.J., AyalaA.G., KilbournR.G.: A prospective randomized trial comparing M-VAC and CISCA chemotherapy for patients with metastatic urothelial tumours. J. Clin. Oncol., 8: 1050–1055, 1990.
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7.
ScherHl., GellerN.L., CurleyT.: Effect of relative cumulative dose-intensity on survival of patients with urothelial cancer treated with M-VAC. J. Clin. Oncol., 11: 400–407, 1993.
8.
SternbergC., de MulderP., van OosteronA.T.: Intensified granulocyte-macrofage colony stimulating factor (GM-CSF) in patients with advanced urothelial tract tumours. Proc. Am. Soc. Clin. Oncol., 11: 210, 1992 (abstr).
