title: A phase II study of mitomycin, fluorouracil, folinic acid, and irinotecan (MFI) for the treatment of transitional cell carcinoma of the bladder.
abstract: OBJECTIVE
  Cisplatin-based chemotherapy is standard care for metastatic transitional cell carcinoma (TCC) of the urinary tract. However it is not appropriate for all patients, particularly those with poor renal function. There is no clear consensus on the optimal regimen for these individuals or for those after cisplatin failure. Here we present data using mitomycin, 5-fluorouracil, and irinotecan (MFI) in these patients.
  
  
  METHODS
  Patients with TCC, who had either received cisplatin-based chemotherapy previously or who were not deemed fit for cisplatin therapy (creatinine clearance was less than 60 ml/min) were eligible for treatment with the experimental combination chemotherapy regimen MFI.
  
  
  RESULTS
  Thirty-six patients were treated with MFI between 2001 and 2004. Overall response rate was 19% and median overall survival (OS) was 5.4 months (95% CI 3.3-8.4 months). The response rate and overall survival in both groups was 19% and 5.4 months, respectively, (95% CI 2.9-7.1 months) in the pretreated and 2.5- 9.3 months in the untreated. The most common toxicity was malaise (grade 3 or 4 = 28%).
  
  
  CONCLUSIONS
  MFI appear to be a combination which requires further investigation in patients where cisplatin and gemcitabine are not applicable.
authors: Department of Medical Oncology, St Bartholomew's Hospital, West Smithfield, London, United Kingdom. mbhattacharyya@doctors.org.uk
authors: Madhumita
authors: M
authors: Bhattacharyya
authors: Tom
authors: T
authors: Powles
authors: Katherine
authors: K
authors: Mutsvangwa
authors: Peter
authors: P
authors: Wilson
authors: Timothy
authors: T
authors: Oliver
authors: Jonathan
authors: J
authors: Shamash
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001706:Biopsy; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives; D002295:Carcinoma, Transitional Cell / Q000188:drug therapy* / Q000401:mortality; D002945:Cisplatin / Q000627:therapeutic use; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D000077146:Irinotecan; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D013997:Time Factors; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy* / Q000401:mortality; D014571:Urologic Neoplasms / Q000188:drug therapy*
chemical_list: D016685:Mitomycin; D000077146:Irinotecan; D002945:Cisplatin; D005472:Fluorouracil; D002166:Camptothecin