[New combination chemotherapy in urological cancers]

Although several effective therapeutic modalities are currently available for each urological cancer, there are still many patients for whom cure is not possible. Interleukin-2 (IL-2) and interferon-alpha (IFN-alpha) are both standard agents for patients with metastatic renal cell carcinoma (RCC). However, only up to 20% of patients can attain a complete response with these agents. It has been reported that for bladder transitional cell carcinoma (TCC), a cisplatin-based chemotherapy such as M-VAC chemotherapy can give patients a prognostic benefit in an adjuvant setting. There has been no therapy to improve upon M-VAC for more than a decade. In this review, several trials with new combination chemotherapies that were developed to overcome the limitations of the current therapy are discussed. These include the combination of IL-2, IFN-alpha and 5-fluorouracil for RCC, paclitaxel/gemcitabine and cisplatin/carboplatin for TCC, and paclitaxel/docetaxel and estramustine for hormone-refractory prostate cancer. The results of initial trials with these new combination therapies are promising. Large scale clinical trials, however, have yet to be done.