A prospective randomized trial comparing MVAC and CISCA chemotherapy for patients with metastatic urothelial tumors.

Abstract

To evaluate the relative efficacy of cisplatin, cyclophosphamide, and Adriamycin (doxorubicin; Adria Laboratories, Columbus, OH) (CISCA) versus methotrexate, vinblastine, Adriamycin, and cisplatin (MVAC), a prospective randomized trial was performed in patients with advanced metastatic urothelial tumors. Patients were stratified by histologic disease type and degree of tumor dissemination. Equal distribution of the clinical characteristics was achieved. One hundred ten patients with metastatic disease of the urinary tract (86 bladder, 16 renal pelvis, seven ureter, one prostatic urethra) met eligibility criteria and were enrolled on study. These represented 82% of the total patients seen during the study period in the Section of Genitourinary Oncology who met the eligibility criteria. The combined complete and partial response rate was significantly higher for patients treated with MVAC than for those treated with CISCA (65% v 46%; P less than .05). The survival duration of MVAC-treated patients was significantly longer than that of CISCA-treated patients (mean, 62.6 weeks; median, 48.3; range, 5.0+ to 162.3+ v mean, 40.4 weeks; median, 36.1; range, 7+ to 147.1+). We conclude that MVAC chemotherapy is superior to CISCA chemotherapy, achieving a higher response rate and a longer survival for equivalent patients with metastatic urothelial tumors.

• Authors: C J Logothetis, F H Dexeus, L Finn, A Sella, R J Amato, A G Ayala, R G Kilbourn
• Journal: Journal of clinical oncology : official journal of the American Society of Clinical Oncology (J Clin Oncol) Vol. 8 Issue 6 Pg. 1050-5 (Jun 1990) ISSN: 0732-183X [Print] United States
• PMID: 2189954 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial)

Chemical References

• Vinblastine
• Doxorubicin
• Cyclophosphamide
• Cisplatin
• Methotrexate

Topics

• Adult
• Aged
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use, toxicity)
• Carcinoma, Transitional Cell (drug therapy, mortality, secondary)
• Cisplatin (administration & dosage, toxicity)
• Cyclophosphamide (administration & dosage, toxicity)
• Doxorubicin (administration & dosage, toxicity)
• Humans
• Methotrexate (administration & dosage, toxicity)
• Middle Aged
• Prospective Studies
• Randomized Controlled Trials as Topic
• Urologic Neoplasms (drug therapy, mortality, secondary)
• Vinblastine (administration & dosage, toxicity)