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M-Vac (Methotrexate, Vinblastine, Doxorubicin and Cisplatin) for Advanced Transitional Cell Carcinoma of the Urothelium

1988; Lippincott Williams & Wilkins; Volume: 139; Issue: 3 Linguagem: Inglês

10.1016/s0022-5347(17)42494-3

1527-3792

Cora N. Sternberg, Alan Yagoda, Howard I. Scher, Robin C. Watson, Harry W. Herr, Michael J. Morse, Pramod C. Sogani, E. Darracott Vaughan, Neil H. Bander, Lora Weiselberg, Nancy L. Geller, Phyllis Hollander, Roberta Lipperman, William R. Fair, Willet F. Whitmore,

Urinary and Genital Oncology Studies

No AccessJournal of UrologyLead Article1 Mar 1988M-Vac (Methotrexate, Vinblastine, Doxorubicin and Cisplatin) for Advanced Transitional Cell Carcinoma of the Urothelium Cora N. Sternberg, Alan Yagoda, Howard I. Scher, Robin C. Watson, Harry W. Herr, Michael J. Morse, Pramod C. Sogani, E. Darracott Vaughan, Neil Bander, Lora R. Weiselberg, Nancy Geller, Phyllis S. Hollander, Roberta Lipperman, William R. Fair, and Willet F. Whitmore Cora N. SternbergCora N. Sternberg , Alan YagodaAlan Yagoda , Howard I. ScherHoward I. Scher , Robin C. WatsonRobin C. Watson , Harry W. HerrHarry W. Herr , Michael J. MorseMichael J. Morse , Pramod C. SoganiPramod C. Sogani , E. Darracott VaughanE. Darracott Vaughan , Neil BanderNeil Bander , Lora R. WeiselbergLora R. Weiselberg , Nancy GellerNancy Geller , Phyllis S. HollanderPhyllis S. Hollander , Roberta LippermanRoberta Lipperman , William R. FairWilliam R. Fair , and Willet F. WhitmoreWillet F. Whitmore View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)42494-3AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Of 92 patients who received methotrexate, vinblastine, doxorubicin and cisplatin complete and partial remissions were observed in 69 ± 10 per cent of 83 adequately treated measurable and evaluable patients with advanced stages (N+M0 and N0M+) transitional cell urothelial cancer. Complete remission was achieved in 37 ± 10 per cent of the patients clinically, pathologically and after surgical resection of residual disease. With 17 of 31 complete responders (55 per cent) surviving for 26+ to 49+ months, the estimated probability of survival at 2 and 3 years was 71 and 55 per cent, respectively. Partial remission occurred in 31 ± 10 per cent of the patients, while 8 per cent had a minor response and 23 per cent had progression with median survivals of 11, 11 and 7 months, respectively. Whereas all metastatic sites responded, including the bone and liver, complete tumor regression was observed more frequently with nodal, pulmonary and local-regional lesions. Brain metastases occurred within 6 to 42 months in 18 per cent of the responders, half of whom never had systemic relapse. Of the remaining 9 patients 2 with nontransitional cell histological tumors did not respond, 5 (5 per cent) were inadequately treated and 2 were excluded from response data because of inevaluable disease parameters but they were free of disease at 16+ and 31+ months. Toxicity was significant, with 20 per cent of the patients experiencing nadir sepsis, 4 per cent a drug-related death, 31 per cent +1 renal toxicity and 41 per cent +1 mucositis. The applications and advantages of the newly proposed international response criteria for bladder cancer are discussed in reference to 25 patients who underwent surgical re-staging, indicating that the disease was understaged clinically in 24 per cent (T less than P), as well as in reference to attainment of true (pathological) complete remission and to other urothelial tract trials. While this therapy seems to have limited antitumor activity against nontransitional cell histological cancer, stage Tis disease and later development of de novo lesions, the regimen is efficacious in selected patients with advanced urothelial tract transitional cell carcinoma. © 1988 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited BydeVere White R, Lara P, Goldman B, Tangen C, Smith D, Wood D, Hussain M and Crawford E (2018) A Sequential Treatment Approach to Myoinvasive Urothelial Cancer: A Phase II Southwest Oncology Group Trial (S0219)Journal of Urology, VOL. 181, NO. 6, (2476-2481), Online publication date: 1-Jun-2009.Wood D (2018) When Does Lymphadenectomy Improve Survival of Patients With Genitourinary Malignancies?Journal of Urology, VOL. 181, NO. 6, (2412-2413), Online publication date: 1-Jun-2009.SIEFKER-RADTKE A, WALSH G, PISTERS L, SHEN Y, SWANSON D, LOGOTHETIS C and MILLIKAN R (2018) Is There a Role for Surgery in the Management of Metastatic Urothelial Cancer? 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Volume 139Issue 3March 1988Page: 461-469 Advertisement Copyright & Permissions© 1988 by The American Urological Association Education and Research, Inc.MetricsAuthor Information Cora N. Sternberg Recipients of the American Cancer Society Clinical Oncology Career Development Award. More articles by this author Alan Yagoda More articles by this author Howard I. Scher Recipients of the American Cancer Society Clinical Oncology Career Development Award. More articles by this author Robin C. Watson More articles by this author Harry W. Herr More articles by this author Michael J. Morse More articles by this author Pramod C. Sogani More articles by this author E. Darracott Vaughan More articles by this author Neil Bander More articles by this author Lora R. Weiselberg More articles by this author Nancy Geller More articles by this author Phyllis S. Hollander More articles by this author Roberta Lipperman More articles by this author William R. Fair More articles by this author Willet F. Whitmore More articles by this author Expand All Advertisement Loading ...