Methotrexate, vinblastine, adriamycin and cisplatin (MVAC) chemotherapy for the treatment of advanced bladder carcinoma.

Thirteen patients with advanced urothelial transitional cell carcinoma were treated with methotrexate, vinblastine, adriamycin and cisplatin combination. No complete remissions were achieved in patients with disseminated diseases; only three out of five patients (60%) with localized tumours in the bladder or perivesical space responded completely. Localized tumour recurrences in the bladder occurred in two of three complete responders at the ninth and tenth months after chemotherapy. Four patients died during or after chemotherapy: one from disease progression and the remainder from chemotherapy complications. Authors conclude that, although 23% complete and 30.8% partial remissions were achieved with the MVAC chemotherapy, strict toxicity monitoring and careful selection of patients are essential because of its non-negligible complications.