M-VAC(Methotrexate, Vinblastine, Doxorubicin and Cisplatin) for Advanced Urothelial Tumors

Lee, Kyung Seop; Park, Choal Hee; Lee, Sung Choon

Abstract

Patients with advanced urothelial tumors that relapse or persist following conventional therapy have poor prognosis. Management of the patients with recurrent local or disseminated urothelial tumors presents a difficult clinical problems. In 1985 Sternberg et al reported 71% of significant tumor regression and 50% of complete clinical remission with M-VAC (methotrexate, vinblastine, doxorubicin and Cisplatin) combination chemotherapy for treatment of advanced urothelial transitional cell carcinomas. Herein, we have experienced 13 cases of M-VAC combination chemotherapy in advanced urothelial tumors. Complete and partial remission was in achieved 46.2 per cent of the patients clinically, while 15.4 percent had a minor response and 38.4 per cent had progression with median survivals of 11.5, 8.5 and 7.4 months. Toxicity was significant. 15.4 per cent of the patients having experienced nadir sepsis, 30.8 per cent mucositis and 7.6 per cent cardiac toxicity. Median cycle length varied from 31.6 to 41.7 days for the first and 5th cycle respectively. This regimen has been efficacious in selected patients with advanced urothelial tumors.