Accelerated cisplatin-based chemotherapy for advanced bladder cancer

Area of Science:

• Oncology
• Urothelial Carcinoma Treatment
• Clinical Trials

Background:

• Advanced urothelial carcinoma has limited treatment options.
• Established chemotherapy regimens like M-VAC and E-MVAC have significant toxicity.
• There is a need for more tolerable and effective treatments.

Purpose of the Study:

• To assess the toxicity and efficacy of an accelerated regimen of cisplatin, vincristine, and methotrexate (MOPq10) in patients with advanced urothelial carcinoma.
• To compare the toxicity profile of MOPq10 with existing M-VAC and E-MVAC regimens.
• To evaluate the palliative benefit of MOPq10 in this patient population.

Main Methods:

• A phase II clinical trial involving 30 consecutive patients with advanced urothelial carcinoma.
• Treatment consisted of four cycles of MOPq10 every 10 days, followed by two cycles at 21-day intervals.
• Data collection included response rates, progression-free survival, overall survival, and toxicity assessment.

Main Results:

• An overall response rate of 63% (95% CI 45-78%) was observed, with 5 complete and 14 partial responses.
• Median progression-free survival was 7.5 months, and median overall survival was 10.5 months.
• Toxicity was moderate, with no treatment-related deaths, and a shorter treatment duration compared to M-VAC/E-MVAC.

Conclusions:

• The MOPq10 regimen demonstrates a notable response rate in advanced urothelial carcinoma.
• MOPq10 offers a potentially less toxic alternative to M-VAC and E-MVAC, with a shorter treatment schedule.
• This accelerated regimen provides palliative benefit to a significant proportion of patients with advanced urothelial carcinoma.