Combination chemotherapy with cis-platinum, adriamycin, mitomycin-C (PAM) in patients with advanced bladder cancer.

Thirty patients with advanced bladder cancer received combination chemotherapy with cis-platinum, adriamycin and mitomycin C. Two patients (6.6%) responded completely and survived 24 and 30 months. Partial response was noted in 14 patients (46.6%) who had a median survival of 9.6 months. Eight patients (26.6%) had stable disease with a median survival of 5 months whereas in 6 patients (20%) their disease progressed with a median survival of 3 months. The amelioration of hematuria, regardless of response, was impressive. Nausea and vomiting were the commonest side effects. Myelotoxicity was mild and reversible. We conclude that PAM chemotherapy is effective and well tolerated in patients with advanced bladder cancer.