[Polychemotherapy using the M-VEC protocol (methotrexate, vinblastine, epirubicin, cisplatin) in advanced urinary bladder cancer--effectiveness and toxicity].

Abstract

We report on preliminary experience with a modified M-VAC (methotrexate, vinblastine, adriamycin and cisplatin) regimen in which adriamycin was replaced by the less toxic 4-epirubicin at equal doses (M-VEC). This study includes 58 patients suffering from advanced bladder cancer, with a minimum observation time of 12 months; each patient received at least two courses of M-VEC (mean follow-up 22 months, average 3.9 cycles). Most (22; 37.9%) of the tumors were T3-4 NO MO; 20 (34.4%) were T3-4 N1-2 MO; and 16 (27.7%) were T3-4 NO-2 M1. Microscopically, 52 (89.6%) were pure transitional cell carcinoma, 5 were (8.6%) squamous cell/carcinomatous transformation; 1 (1.8%) sarcoma was found. Chemotherapy was given as palliative treatment in 34 (58.6%) patients, as neo-adjuvant therapy in 19 (32.8%) cases and as adjuvant therapy in 5 (8.6%) patients. The overall response rate was 72.3% (CR = 51.7%), with a mean duration of response of 18+ months. The disease-free survival so far amounts to 24/58 (41.4%). Squamous cell carcinoma does not respond to M-VEC. Locally advanced bladder cancer (T3-4 NO-2 MO) responds significantly better than metastatic (M1) disease (78.5% vs 56.2%), resulting in an increased survival rate (57% versus 12.5%) after 22 months. The toxicity of M-VEC is considerably lower than has been reported for other regimens (M-VAC, CMV, CM). The toxic effects included mucositis (3%), nadir sepsis (2.4%) and drug-related death (2.4%).

• Authors: J Rassweiler, U Rüther, K Bäuerle, P Bub, P Jipp, F Eisenberger
• Journal: Der Urologe. Ausg. A (Urologe A) Vol. 28 Issue 1 Pg. 25-30 (Jan 1989) ISSN: 0340-2592 [Print] Germany
• Vernacular Title: Polychemotherapie nach dem M-VEC Schema (Methotrexat, Vinblastin, Epirubicin, Cisplatin) beim fortgeschrittenen Harnblasenkarzinom--Effektivität und Toxizität.
• PMID: 2922897 (Publication Type: English Abstract, Journal Article)

Chemical References

• Epirubicin
• Vinblastine
• Cisplatin
• Methotrexate

Topics

• Aged
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Carcinoma, Transitional Cell (drug therapy, pathology, surgery)
• Cisplatin (administration & dosage)
• Combined Modality Therapy
• Epirubicin (administration & dosage)
• Female
• Humans
• Male
• Methotrexate (administration & dosage)
• Neoplasm Metastasis
• Neoplasm Staging
• Urinary Bladder (surgery)
• Urinary Bladder Neoplasms (drug therapy, pathology, surgery)
• Vinblastine (administration & dosage)