Preliminary results of M-VAC (methotrexate, vinblastine, doxorubicin and cisplatin) for transitional cell carcinoma of the urothelium Journal Article

  

Authors:	Sternberg, C. N.; Yagoda, A.; Scher, H. I.; Watson, R. C.; Ahmed, T.; Weiselberg, L. R.; Geller, N.; Hollander, P. S.; Herr, H. W.; Sogani, P. C.; Morse, M. J.; Whitmore, W. F.
Article Title:	Preliminary results of M-VAC (methotrexate, vinblastine, doxorubicin and cisplatin) for transitional cell carcinoma of the urothelium
Abstract:	The M-VAC (methotrexate, vinblastine, doxorubicin and cisplatin) regimen was used to treat 25 patients with transitional cell carcinoma of the urothelial tract. Treatment consisted of monthly cycles of 30 mg. per m.2 methotrexate, followed 24 hours later by 3 mg. per m.2 vinblastine, 30 mg. per m.2 doxorubicin and 70 mg. per m.2 cisplatin, and concluded with repeat vinblastine and methotrexate on days 15 and 22. Significant tumor regression was noted in 71 per cent of the patients. Complete clinical remission was observed in 12 of 24 patients (50 per cent, 95 per cent confidence limits 30 to 70 per cent) with bidimensionally measurable indicator lesions, 6 of whom had pathological confirmation. After surgical exploration 4 patients required downstaging to a partial remission. The median duration of response has not yet been reached at 9.5 plus months, range 4.5 plus to 16 plus. Five patients (21 per cent) had a partial clinical remission for 4 to 8 plus months, 1 had a minor response for 4 months and 1 had stable disease for 11 months. All metastatic sites responded, including bone (6 of 8 cases), liver (3 of 5), locoregional (12 of 17) and intravesical (6 of 7) disease. Toxicity included moderately severe myelosuppression that resulted in nadir sepsis in 4 patients and a drug-related death in 1, mild to moderate anorexia, vomiting, alopecia and renal dysfunction. These preliminary results suggest that treatment with methotrexate, vinblastine, doxorubicin and cisplatin is extremely effective against locoregional and disseminated urothelial tract tumors, with the expectation (95 per cent confidence limits) of inducing objective tumor regression in 53 to 89 per cent of the cases.
Keywords:	clinical article; cisplatin; doxorubicin; cancer combination chemotherapy; drug efficacy; skin toxicity; methotrexate; anorexia; metastasis; nephrotoxicity; vomiting; dexamethasone; tumor regression; pathology; vinblastine; gastrointestinal toxicity; urothelium; kidney; drug therapy; vinblastine sulfate; alopecia; transitional cell carcinoma; metoclopramide; adverse drug reaction; therapy; intravenous drug administration; bladder; diphenhydramine; bone marrow depression; intoxication; human; priority journal; blood and hemopoietic system
Journal Title:	Journal of Urology
Volume:	133
Issue:	3
ISSN:	0022-5347
Publisher:	Elsevier Science, Inc.
Date Published:	1985-03-01
Start Page:	403
End Page:	407
Language:	English
DOI:	10.1016/s0022-5347(17)48996-8
PROVIDER:	scopus
PUBMED:	4038749
DOI/URL:	https://www.scopus.com/inward/record.uri?eid=2-s2.0-0021910302&doi=10.1016%2fS0022-5347%2817%2948996-8&partnerID=40&md5=96a0ca24b142ba50176b0c250c6e5283
Notes:	Article -- Export Date: 26 October 2021 -- Source: Scopus

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