The role of cisplatin-based chemotherapy in advanced urothelial tract cancer.
Cisplatin and methotrexate used singly are the most active agents against transitional cell carcinoma of the urothelium, inducing remission in approximately 30% of cases. Other agents demonstrating some activity include vinblastine, vincristine, and, to a lesser extent, fluorouracil, mitomycin C, and amsacrine. Most multidrug combinations have not proven to be more effective than single-drug therapy; however, there is some indication that response and percent of complete remission (CR) is increased with cisplatin plus doxorubicin, and with CMV (cisplatin, methotrexate, vinblastine) and M-VAC (methotrexate, vinblastine, doxorubicin, cisplatin) regimens. With the latter two regimens, approximately 20% to 35% of cases achieve CR that persists in selected cases for 2 to 4 years. Such results against advanced transitional cell carcinoma with CMV and M-VAC have led to their use in neoadjuvant trials for this chemotherapeutically responsive tumor.
Yagoda
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Division of Urology, New York Hospital, Cornell Medical Center, NY 10021.
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002295:Carcinoma, Transitional Cell / Q000188:drug therapy*; D002945:Cisplatin / Q000008:administration & dosage* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage / Q000627:therapeutic use; D014565:Urogenital Neoplasms / Q000188:drug therapy*
D002945:Cisplatin; D008727:Methotrexate