title: Metastatic bladder cancer: advances in treatment.
abstract: At present, a combination of cisplatin, methotrexate, vinblastine and doxorubicin is the most widely used chemotherapy for metastatic bladder cancer. However, long-term follow-up shows that this combination may have little effect on survival. In addition, this regimen is toxic. New agents are needed which combine efficacy with good safety profiles. Agents which have been investigated include gallium nitrate, interferon-alpha and paclitaxel both as single agents and in combination with established cytotoxic drugs. A number of studies have been conducted in bladder cancer with the novel nucleoside analogue, gemcitabine. Response rates of up to 33% have been recorded in two phase II studies. Gemcitabine was well tolerated in both studies with few of the side-effects normally associated with cytotoxic drugs. A third study is ongoing.
authors.affiliation: Section of Hematology/Oncology, University of Chicago, Illinois, USA.
authors.forename: W M
authors.initials: WM
authors.lastname: Stadler
authors.forename: T M
authors.initials: TM
authors.lastname: Kuzel
authors.forename: D
authors.initials: D
authors.lastname: Raghavan
authors.forename: E
authors.initials: E
authors.lastname: Levine
authors.forename: N J
authors.initials: NJ
authors.lastname: Vogelzang
authors.forename: B
authors.initials: B
authors.lastname: Roth
authors.forename: F A
authors.initials: FA
authors.lastname: Dorr
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D017322:Clinical Trials, Phase II as Topic; D003841:Deoxycytidine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy* / Q000473:pathology; D000093542:Gemcitabine
chemical_list: D000964:Antimetabolites, Antineoplastic; D003841:Deoxycytidine; D000093542:Gemcitabine