Overview of systemic treatment of bladder cancer and results with M-VAC therapy.
Cytotoxic chemotherapy is playing an increasingly important role for advanced disease, and is being properly evaluated in prospective trials as neoadjuvant therapy. There has been no major undertaking to examine adjuvant treatment, and hopefully randomized studies will be started in the future. There is sparse data concerning the effectiveness of immunological agents for treatment of this tumor, and phase II efficacy studies are needed. Future studies will need to define more accurately the poor-risk group in whom new agents or regimens using a more intensive schedule, perhaps with G-CSF, can be explored as initial therapy.
Yagoda
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Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York 10021.
D000970:Antineoplastic Agents / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D004317:Doxorubicin / Q000008:administration & dosage; D004341:Drug Evaluation; D006801:Humans; D008727:Methotrexate / Q000008:administration & dosage; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D015996:Survival Rate; D014481:United States / Q000453:epidemiology; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D014747:Vinblastine / Q000008:administration & dosage
D000970:Antineoplastic Agents; D014747:Vinblastine; D004317:Doxorubicin; D002945:Cisplatin; D008727:Methotrexate