Ryan C W, Vogelzang N J
Section of Hematology/Oncology, University of Chicago Medical Centre, 5841 S. Maryland Avenue, MC 2115, Chicago, IL 60637, USA.
Expert Opin Pharmacother. 2000 Mar;1(3):547-53. doi: 10.1517/14656566.1.3.547.
New agents are available for the treatment of metastatic transitional cell carcinoma of the bladder. In the US, the combination of methotrexate, vinblastine, doxorubicin and cisplatin (M-VAC) remains the standard chemotherapy regimen for advanced bladder cancer. Gemcitabine (2',2'-difluorodeoxycytidine [dFdC]) is a relatively new agent with a favourable toxicity profile that has demonstrated activity against a number of solid tumours in both preclinical and clinical studies. Single-agent gemcitabine has shown activity in bladder cancer in both pretreated and chemotherapy-naïve patients. The combination of gemcitabine plus cisplatin is a regimen with significant activity and moderate toxicity in bladder cancer patients. A randomised trial of gemcitabine plus cisplatin versus M-VAC has completed accrual but has not yet been reported. New combination studies of gemcitabine with other chemotherapy agents, including the taxanes, are ongoing.
有新的药物可用于治疗转移性膀胱移行细胞癌。在美国，甲氨蝶呤、长春碱、阿霉素和顺铂联合方案（M-VAC）仍然是晚期膀胱癌的标准化疗方案。吉西他滨（2',2'-二氟脱氧胞苷[dFdC]）是一种相对较新的药物，其毒性特征良好，在临床前和临床研究中均已证明对多种实体瘤具有活性。单药吉西他滨在经治和未经化疗的膀胱癌患者中均显示出活性。吉西他滨联合顺铂方案在膀胱癌患者中具有显著活性且毒性中等。一项吉西他滨联合顺铂对比M-VAC的随机试验已完成病例入组，但尚未报道结果。吉西他滨与其他化疗药物（包括紫杉烷类）的新联合研究正在进行中。
