Analyses of factors affecting the outcome of combination chemotherapy in patients with advanced bladder cancer.

Abstract

Thirty-seven patients with advanced bladder carcinoma were treated with a combination of methotrexate, vinblastine, adriamycin and cisplatin (M-VAC). Attempts were made to identify the factors related to the results of the present regimen using multivariate analyses. Factors related to the results were presence of distant metastases and prior chemotherapy. The effect of the M-VAC chemotherapy was disappointing in most patients with distant metastases and prior chemotherapy. This was prominent in patients with prior chemotherapy including cisplatin. These results seem to show clinically the development of resistance to cisplatin in advanced bladder cancer. Methods to overcome this resistance should be studied.