Bellmunt J, Albiol S, de Olano A Ramírez, Pujadas J, Maroto P
Medical Oncology Service, Hospital General Universitari Vall d'Hebron, Barcelona, Spain.
Ann Oncol. 2006 May;17 Suppl 5:v113-7. doi: 10.1093/annonc/mdj964.
M-VAC (cisplatin, methotrexate, adriamycin, vinblastine) combination chemotherapy has been for long time the standard of care in fit patient with advanced urothelial tumors. Gemcitabine/cisplatin with similar results and an improved toxicity profile has proved to be a new standard alternative. Whether or not we can improve survival with newer triplet regimens will depend upon the results of ongoing phase III trials. In addition to the new active drug combinations and targeted therapies, new approaches are emerging for treatment. Chemotherapy optimization using molecular markers predicting chemosensitivity are being applied. There is an obvious need to incorporate in clinical trials a systematic translational approach to explain both our successes and our failures.
M-VAC（顺铂、甲氨蝶呤、阿霉素、长春碱）联合化疗长期以来一直是晚期尿路上皮肿瘤合适患者的标准治疗方案。吉西他滨/顺铂具有相似的疗效且毒性特征有所改善，已被证明是一种新的标准替代方案。我们能否通过更新的三联疗法提高生存率将取决于正在进行的III期试验结果。除了新的活性药物组合和靶向治疗外，新的治疗方法也正在出现。利用预测化疗敏感性的分子标志物进行化疗优化正在得到应用。显然有必要在临床试验中纳入一种系统的转化方法，以解释我们的成功与失败。
