Carboplatin, methotrexate, vinblastine and epirubicin (Carbo-MVE) for transitional cell bladder carcinoma

Abstract

Background: MVAC is considered the most effective chemotherapy regimen for transitional cell bladder carcinoma However, due to its significant toxic effects we substituted carboplatin for cisplatin and epirubicin for adriamycin in an attempt to produce the same response with less toxicity. Patients and methods: Twenty-seven patients with invasive transitional cell bladder carcinoma received Carbo-MVE: carboplatin (300 mgr/m2 d2), methotrexate (30 mgr/m2 dl, 15, 22), vinblastine (3 mgr/m2 d2,15, 22) and epirubicin (30 mgr/m2 d2) every 4 weeks. Results: There were 2 complete clinical responses (8.4%), 5 partial clinical responses (20.8%), 8 stabilizations (33.3%) and 9 progressions (37.5%). The overall clinical response rate was 29.2% (ll%-47.4%, 95% CI), but 2 partial clinical remissions were not pathologically confirmed; were they to be considered as non-responses the response rate would fall even lower (20.8%). Toxicity was moderately severe, with 77.8% developing WHO grade 111-IV granulocytopenia, 22.2% grade III-IV thrombocytopenia and 59.3% grade II-in vomiting. There were no toxic deaths nor any renal toxicity. Conclusions: Our results suggest that Carbo-MVE is less active and at least as hematotoxic as multiagent CDDP-based regimens. © 1993 Kluwer Academic Publishers.